Substituted imidazole-4-carboxamides as cholecystokinin-1 receptor modulators

ABSTRACT

Certain novel substituted imidazole 4-carboxamides are ligands of the human cholecystokinin receptor and, in particular, are selective ligands of the human cholecystokinin-1 receptor (CCK-1R). They are therefore useful for the treatment, control, or prevention of diseases and disorders responsive to the modulation of CCK-1R, such as obesity, and diabetes.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a U.S. National Phase application under 35 U.S.C. §371 of PCT Application No. PCT/US2007/008956, filed 10 Apr. 2007, which claims priority from and the benefit of U.S. Provisional Application No. 60/792,134, filed Apr. 14, 2006.

BACKGROUND OF THE INVENTION

Obesity is a major health concern in Western societies. It is estimated that about 97 million adults in the United States are overweight or obese. Obesity is now recognized as a chronic disease that requires treatment to reduce its associated health risks. The medical problems associated with obesity, which can be serious and life-threatening, include hypertension; type 2 diabetes mellitus; elevated plasma insulin concentrations; insulin resistance; hyperinsulinemia; glucose intolerance; dyslipidemias; hyperlipidemia; endometrial, breast, prostate and colon cancer; osteoarthritis; respiratory complications, such as obstructive sleep apnea; cholescystitis; cholelithiasis; gout; gallstones; gall bladder disease; respiratory problems; psychological disorders (such as depression, eating disorders, distorted body image and low self esteem); arteriosclerosis; heart disease; abnormal heart rhythms; angina pectoris; and heart arrythmias (Kopelman, P. G., Nature 404, 635-643 (2000)). Obesity is further associated with premature death and with a significant increase in mortality and morbidity from stroke, myocardial infarction, congestive heart failure, coronary heart disease, and sudden death. Recent studies have found that obesity and its associated health risks also affect children and adolescents. According to the Centers for Disease Control, 15 percent of children and adolescents are defined as overweight and obese, a doubling since the early 1970s Important outcomes for the treatment of obesity include weight loss, and weight management to improve cardiovascular and metabolic health and to reduce obesity-related morbidity and mortality. It has been shown that 5-10% loss of body weight can substantially improve metabolic values, such as blood glucose, blood pressure, and lipid concentrations, and may reduce morbidity and mortality.

Cholecystokinin (CCK) is a brain-gut peptide that acts as a gastrointestinal hormone, neurotransmitter and neuromodulator in the central and the peripheral nervous systems. It has been shown that CCK is released from mucosal 1-cells of the duodenum and jejunum in response to a meal, particularly in response to fat or protein in the meal. Once released, CCK initiates a number of responses coordinated to promote digestion and regulate food intake, including mediating bile emptying from the gall bladder, regulating the release of digestive enzymes from the pancreas, controlling gastric emptying by regulation of the pyloric sphincter, as well as neuronal signaling to the central nervous system via vagal afferent neurons. Neuronal CCK is believed to mediate a number of events within the CNS, including modulating dopaminergic neurotransmission and anxiogenic effects, as well as affecting cognition and nociception. See, e.g., J. N. Crawley and R. L. Corwin, 1994, Peptides, 15:731-755; N. S. Baber, C. T. Dourish, and D. R. Hill, Pain (1989), 39(3), 307-28; and P. De Tullio, J. Delarge and B. Pirotte, Expert Opinion on Investigational Drugs (2000), 9(1), 129-146. Cholecystokinin has been shown to mediate its diverse hormonal and neuromodulatory functions through two receptor subtypes: the CCK-A (CCK1) and CCK-B (CCK2) subtypes (see, e.g., G. N. Woodruff and J. Hughes, Annu. Rev. Pharmacol. Toxicol. (1991), 31: 469-501). Both CCK-1 and CCK-2 receptor subtypes belong to the seven transmembrane G-protein-coupled superfamily of receptors. A number of studies suggest that CCK mediates its satiety effect through the CCK-1 receptor, which relays the postprandial satiety signal via the vagal afferents to the CNS. See, e.g., G. P. Smith et al., Science 213 (1981) pp. 1036-1037; and J. N. Crawley et al., J. Pharmacol. Exp. Ther., 257 (1991) pp. 1076-1080. The nucleotide sequences of the peripheral CCK-1 receptor and central CCK-1 receptor are identical in humans. See, e.g., S. A. Wank et al., (1994), NY Acad. Sci. 713, pp. 49-66.

It has been reported that cholecystokinin (CCK) inhibits gastric emptying and increases satiety in a variety of species, including humans, resulting in a reduction of food intake (Moran, T. H. Physiology & Behavior 2004, 82, 175-180). Selective CCK1R antagonists have been shown to reverse the anorexigenic effect of CCK thus increasing food intake and meal size in several species, including humans (Beglinger, C. et. al. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2001, 280, R1149-R1154). Conversely, administration of CCK1R agonists to a variety of species, including humans, results in a reduction of food intake (Geary, N. Physiology & Behavior 2004, 81, 719-733). Consequently, selective small molecule CCK1R agonists are useful for the treatment or prevention of obesity and related metabolic disorders such as diabetes and dyslipidemia (Woods, S. C. Am. J. Gastrointest. Liver Physiol. 2004, 286, G7-13; Moran, T. H., Kinzig, K. P. Am. J. Gastrointest. Liver Physiol. 2004, 286, G183-G188). In humans, bulimia nervosa has been linked with reduced secretion of postprandial CCK (Deylin, M. J. et. al. J. Pharmacol. Exp. Ther. 1987, 241, 100-116), lower CCK concentrations in cerebrospinal fluid (Lydiard, R. B. et. al. Am. J. Psychiatry 1993, 150, 1099-1101), and lower CCK levels in T lymphocytes which could reflect central CCK secretion levels (Brambilla, F. et. al. Psychiatry Research 1995, 37, 51-56). Accordingly, CCK1R agonists are also useful in treating, preventing, or diagnosing bulimia nervosa and related eating disorders.

CCK agonists stimulate gallbladder contraction, stimulate pancreatic enzyme secretions, stimulate intestinal blood flow, and affect intestinal motor activity (See Rehfeld, J. F. Best Practice & Res. Clin. Endocrin. & Metab. 2004, 18, 569-586). Consequently, CCK1R agonists are useful for the treatment, prevention, or diagnosis of disorders related to the gall bladder including, but not limited to, cholecystitis (inflammation of the gallbladder) and cholelithiasis (gallstones). Furthermore, CCK agonists are useful for the treatment, prevention, or diagnosis of disorders related to the pancreas. Finally, CCK1R agonists are useful for the treatment, prevention, or diagnosis of disorders related to the gastrointestinal tract and gastrointestinal motility. CCK receptors are abundant in the central nervous system, and agonists can be used for the treatment, prevention, or diagnosis of emotional or sexual behavior disorders and memory disorders (Itoh, S.; et. al. Drug Develop. Res. 1990, 21, 257-276). Furthermore, CCK agonists can be used for the treatment, prevention, or diagnosis of tardive dyskinesia (Nishikawa, T. et. al. Prog. Neuropsycho-pharmacol. Biol. Psych. 1988, 12, 903-812; Bignon, E. et. al. J. Pharm. Exp. Ther. 1999, 289, 752-761), Parkinson's disease (Bednar, I. et. al. Biogenic Amine, 1996, 12, 275-284), schizophrenia, and psychosis (Crawley, J. N. Trends in Pharmacol. Sci., 1991, 12, 232-236).

Imidazole compounds useful for the treatment of obesity and obesity related disorders have been disclosed in WO 01/085723, WO 03/040107, WO 03/063781, WO 03/007887, WO 2004/094407, WO 2005/009974, WO 2005/040130, WO 2005/063716, WO 2005/095354, US 2005/0054679, US 2005/0124660, US 2005/0197377, U.S. Pat. No. 6,960,601, and J. Med. Chem. 2005, 48, 1823-1838. Other imidazoles are disclosed in J. Med. Chem. 2005, 48, 2638-2645; J. Med. Chem., 2002, 45, 4655-4668; J. Med. Chem. 2000, 43, 3168-3185; and J. Med. Chem. 1997, 40, 1634-1647.

Because of the unresolved deficiencies of the various pharmacological agents discussed above, there is a continuing need for a weight loss treatment with enhanced efficacy and fewer undesirable side effects. The instant invention addresses this problem by providing CCK receptor agonists, and in particular selective agonists of the cholecystokinin-1 receptor (CCK-1R), useful in the treatment and prevention of obesity and obesity-related disorders, including diabetes.

It is therefore an object of the present invention to provide substituted imidazole 4-carboxamides which are selective agonists of the cholecystokinin-1 (CCK-1R) receptor. It is another object of the present invention to provide substituted imidazole 4-carboxamides which are cholecystokinin-1 receptor agonists and thereby useful to treat obesity, diabetes, and obesity related disorders. It is another object of the present invention to provide pharmaceutical compositions comprising the cholecystokinin-1 receptor agonists of the present invention with a pharmaceutically acceptable carrier. It is another object of the present invention to provide methods for the treatment or prevention of disorders, diseases, or conditions responsive to the activation of the cholecystokinin-1 receptor in a mammal in need thereof by administering the compounds and pharmaceutical compositions of the present invention. It is another object of the present invention to provide methods for the treatment or prevention of obesity, diabetes mellitus, and obesity related disorders by administering the compounds and pharmaceutical compositions of the present invention to a mammal in need thereof. These and other objects will become readily apparent from the detailed description that follows.

SUMMARY OF THE INVENTION

The present invention relates to novel substituted imidazole 4-carboxamides of formula I:

The compounds of formula I are effective as cholecystokinin receptor ligands and are particularly effective as selective ligands of the cholecystokinin-1 receptor. They are therefore useful for the treatment and/or prevention of disorders responsive to the modulation of the cholecystokinin-1 receptor, such as obesity, diabetes, and obesity-related disorders.

The present invention also relates to pharmaceutical compositions comprising the compounds of the present invention and a pharmaceutically acceptable carrier.

The present invention also relates to methods for the treatment or prevention of disorders, diseases, or conditions responsive to the modulation of the cholecystokinin-1 receptor in a mammal in need thereof by administering the compounds and pharmaceutical compositions of the present invention.

The present invention further relates to the use of the compounds of the present invention in the preparation of a medicament useful for the treatment or prevention of disorders, diseases, or conditions responsive to the modulation of the cholecystokinin-1 receptor in a mammal in need thereof by administering the compounds and pharmaceutical compositions of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to substituted imidazole 4-carboxamides useful as cholecystokinin receptor modulators, in particular, as selective cholecystokinin-1 receptor agonists. Compounds of the present invention are described by formula I;

or a pharmaceutically acceptable salt thereof; wherein X is N or CR¹⁶; R¹, R², R³ and R⁴ are each independently selected from the group consisting of:

(1) hydrogen,

(2) halogen,

-   -   (3) —OH,     -   (4) —C₁₋₆alkyl, and     -   (5) —C₁₋₆alkoxy,         wherein alkyl and alkoxy are unsubstituted or substituted with         one to five substituents independently selected from halogen,         —OH, C₁₋₆alkyl, and C₁₋₆alkoxy,         or R² and R³ or R³ and R⁴ together with the atoms to which they         are attached form a 4-8 membered ring containing 0-2 heteroatoms         independently selected from oxygen, sulfur, and N—R¹⁵, and         wherein the 4-8 membered ring is unsubstituted or substituted         with a substituent selected from —OH, halogen, C₁₋₆alkyl, and         C₁₋₆alkoxy;         R⁵, R⁶ and R⁷ are each independently selected from the group         consisting of:     -   (1) hydrogen,     -   (2) halogen,     -   (3) —OH,     -   (4) —C₁₋₆alkyl, and     -   (5) —C₁₋₆alkoxy,         wherein alkyl and alkoxy are unsubstituted or substituted with         one to five substituents independently selected from halogen,         —OH, C₁₋₆alkyl, and C₁₋₆alkoxy,         or R⁵ and R⁶ together with the atoms to which they are attached         form a 4-8 membered ring containing 0-2 heteroatoms         independently selected from oxygen, sulfur, and N—R¹⁵, and         wherein the 4-8 membered ring is unsubstituted or substituted         with a substituent selected from —OH, halogen, C₁₋₆alkyl, and         C₁₋₆alkoxy;         R⁸ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) halogen,     -   (3) —C₁₋₆alkyl,     -   (4) —C₁₋₆alkoxy, and     -   (5) —C₃₋₆cycloalkyl,         wherein alkyl, alkoxy and cycloalkyl are unsubstituted or         substituted with one to five substituents selected from halogen         and —OH;         each R⁹ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) —CF₃,     -   (3) —OH,     -   (4) —CN,     -   (5) —C₁₋₆alkyl,     -   (6) —C₁₋₆alkoxy,     -   (7) —(CH₂)_(n)C₃₋₈cycloalkyl,     -   (8) —(CH₂)_(n)NR¹¹R¹²,     -   (9) -a 5-10 membered aromatic monocyclic or bicyclic         heterocyclic ring, and     -   (10) phenyl,         wherein alkyl and alkoxy are unsubstituted or substituted with         —OH or phenyl, and wherein the heterocyclic ring and phenyl are         unsubstituted or substituted with one or more substituents         selected from C₁₋₆alkyl, —OH, C₁₋₆alkoxy, —CF₃, —CN, and         halogen;         each R¹⁰ is independently selected from the group consisting of:     -   (1) —C₁₋₆alkyl,     -   (2) -aryl,     -   (3) -heteroaryl,     -   (4) —C₂₋₈ heterocycloalkyl, and     -   (5) —C₃₋₈cycloalkyl,         wherein alkyl is unsubstituted, and aryl, heteroaryl,         heterocycloalkyl, and C₃₋₈cycloalkyl are unsubstituted or         substituted with one to five substituents independently selected         from C₁₋₆alkyl;         each R¹¹ and R¹² is independently selected from the group         consisting of:     -   (1) hydrogen,     -   (2) —C₁₋₆alkyl,     -   (3) —(CH₂)_(n)C₃₋₈cycloalkyl, and     -   (4) —(CH₂)_(n) heterocycloalkyl,         or R¹¹ and R¹² together with the nitrogen to which they are         attached form a 4-8 membered heterocyclic ring containing 0-2         additional heteroatoms selected from oxygen, sulfur, and NR¹⁵,         and wherein alkyl, cycloalkyl, heterocycloalkyl and the 4-8         membered heterocyclic ring are unsubstituted or substituted with         one to five substituents independently selected from halogen,         —OH, oxo, —CN, CF₃, C₁-C₆alkyl, C₁₋₆alkoxy, —(CH₂)_(n)CO₂H,         —(CH₂)_(n)CO₂C₁₋₆alkyl, and —(CH₂)_(n)SO₃H, and alkyl and alkoxy         are unsubstituted or substituted with one to five substituents         selected from halogen, —CO₂H, and —SO₃H;         each R¹³ is independently hydrogen or R¹⁴;         each R¹⁴ is independently selected from the group consisting of:     -   (1) —C₁₋₆alkyl,     -   (2) —(CH₂)_(n)C₃₋₈cycloalkyl,     -   (3) —(CH₂)_(n)C₂₋₈heterocycloalkyl,     -   (4) —(CH₂)_(n)aryl, and     -   (5) —(CH₂)_(n)heteroaryl,         wherein alkyl, cycloalkyl, heterocycloalkyl, aryl and heteroaryl         are unsubstituted or substituted with one to five substituents         independently selected from —OH, oxo, halogen, —CN,         —(CH₂)_(n)CO₂H, —SO₃H, C₁₋₆alkyl, and C₁₋₆alkoxy, and alkyl and         alkoxy are unsubstituted or substituted with one to five         substituents selected from halogen, —OH, —CO₂H, and —SO₃H;         each R¹⁵ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) —C₁₋₆alkyl,     -   (3) —C₃₋₈cycloalkyl,     -   (4) —SO₂R¹⁴,     -   (5) —COR¹³, and     -   (6) —CO₂R¹⁴,         wherein alkyl and cycloalkyl are unsubstituted or substituted         with one to five substituents selected from halogen, —OH, and         —(CH₂)_(n)CO₂H;         each R¹⁶ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) —CF₃,     -   (3) —OH,     -   (4) —CN,     -   (5) —C₁₋₆alkyl,     -   (6) —C₁₋₆alkoxy,     -   (7) —(CH₂)_(n)C₃₋₈cycloalkyl,     -   (8) —(CH₂)_(n)NR¹¹R¹²,     -   (9) -a 5-10 membered aromatic monocyclic or bicyclic         heterocyclic ring, and     -   (10) phenyl,         wherein alkyl and alkoxy are unsubstituted or substituted with         —OH or phenyl, and wherein cycloalkyl, the heterocyclic ring and         phenyl are unsubstituted or substituted with one or more         substituents selected from C₁₋₆alkyl, —OH, C₁₋₆alkoxy, —CF₃,         —CN, and halogen;         each n is independently 0, 1, 2, or 3;         each m is independently 0, 1, 2, 3 or 4; and         each p is independently 0, 1, 2, 3 or 4.

In a further embodiment of the compounds of the present invention, there are provided compounds of formula II:

or a pharmaceutically acceptable salt thereof; wherein R¹, R², R³ and R⁴ are each independently selected from the group consisting of:

-   -   (1) hydrogen,     -   (2) halogen,     -   (3) —OH,     -   (4) —C₁₋₆alkyl, and     -   (5) —C₁₋₆alkoxy,         wherein alkyl and alkoxy are unsubstituted or substituted with         one to five substituents selected from halogen, —OH, C₁₋₆alkyl,         and C₁₋₆alkoxy;         R⁵, R⁶ and R⁷ are each independently selected from the group         consisting of:     -   (1) hydrogen,     -   (2) halogen,     -   (3) —C₁₋₆alkyl, and     -   (4) —C₁₋₆alkoxy,         wherein alkyl and alkoxy are unsubstituted or substituted with         one to five substituents selected from halogen, —OH, C₁₋₆alkyl,         and C₁₋₆alkoxy;         R⁸ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) halogen,     -   (3) —C₁₋₆alkyl,     -   (4) —C₁₋₆alkoxy, and     -   (5) —C₃₋₆cycloalkyl;         each R⁹ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) —CF₃,     -   (3) —OH,     -   (4) —CN,     -   (5) —C₁₋₆alkyl, unsubstituted or substituted with —OH or phenyl,     -   (6) —C₁₋₆alkoxy,     -   (7) —(CH₂)_(n)C₃₋₈cycloalkyl,     -   (8) —(CH₂)_(n)NR¹¹R¹²,     -   (9) -a 5-10 membered aromatic monocyclic or bicyclic         heterocyclic ring, and     -   (10) phenyl, unsubstituted or substituted with one or more         substituents selected from C₁₋₆alkyl, —OH, C₁₋₆alkoxy, —CF₃,         —CN, and halogen;         each R¹⁰ is independently selected from the group consisting of:     -   (1) —C₁₋₆alkyl,     -   (2) -aryl, unsubstituted or substituted with one to five         substituents selected from C₁₋₆alkyl, and alkyl is unsubstituted         or substituted with one to five substituents independently         selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl,     -   (3) -heteroaryl, unsubstituted or substituted with one to five         substituents selected from C₁₋₆alkyl, and alkyl is unsubstituted         or substituted with one to five substituents independently         selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl,     -   (4) —C₂₋₈heterocycloalkyl, unsubstituted or substituted with one         to five substituents selected from C₁₋₆alkyl, and alkyl is         unsubstituted or substituted with one to five substituents         independently selected from halogen, —OH, —SO₃H, —CO₂H, and         —CO₂C₁₋₆alkyl, and     -   (5) —C₃₋₈cycloalkyl, unsubstituted or substituted with one to         five substituents selected from C₁₋₆alkyl, and alkyl is         unsubstituted or substituted with one to five substituents         selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl;         each R¹¹ and R¹² is independently selected from the group         consisting of:     -   (1) hydrogen,     -   (2) —C₁₋₆alkyl, unsubstituted or substituted with one to five         halogens,     -   (3) —(CH₂)_(n)C₃₋₈cycloalkyl, unsubstituted or substituted with         one to five substituents selected from halogen, —OH, and         —(CH₂)_(n)CO₂H, and     -   (4) —(CH₂)_(n)heterocycloalkyl, unsubstituted or substituted         with one to five substituents selected from halogen, —OH, oxo,         C₁₋₆ alkyl, CF₃, and —(CH₂)_(n)CO₂H,         or R¹¹ and R¹² together with the nitrogen to which they are         attached form a 4-8 membered heterocyclic ring containing 0-2         additional heteroatoms selected from oxygen, sulfur, and NR¹⁵,         and wherein the 4-8 membered heterocyclic ring is unsubstituted         or substituted with one to five substituents independently         selected from —OH, oxo, halogen, —CN, —(CH₂)_(n)CO₂H,         —(CH₂)_(n)CO₂C₁₋₆alkyl, —(CH₂)_(n)SO₃H, C₁-C₆alkyl, and         C₁₋₆alkoxy, and alkyl and alkoxy are unsubstituted or         substituted with one to five substituents selected from halogen,         —CO₂H, and —SO₃H;         each R¹³ is independently hydrogen or R¹⁴;         each R¹⁴ is independently selected from the group consisting of:     -   (1) —C₁₋₆alkyl, unsubstituted or substituted with one to five         substituents selected from halogen, —OH, —CO₂H, and —SO₃H,     -   (2) —(CH₂)_(n)C₃₋₈cycloalkyl, unsubstituted or substituted with         one to five substituents selected from halogen, —OH, —CO₂H, and         —SO₃H,     -   (3) —(CH₂)_(n)C₂₋₈heterocycloalkyl, unsubstituted or substituted         with one to five substituents selected from halogen, —OH, oxo,         —C₁₋₆alkyl, C₁₋₆alkoxy, and —(CH₂)_(n)CO₂H, and alkyl and alkoxy         are unsubstituted or substituted with one to five halogens,     -   (4) —(CH₂)_(n)aryl, unsubstituted or substituted with one to         five substituents selected from —OH, halogen, —CN, —CO₂H, —SO₃H,         C₁-C₆alkyl, and C₁₋₆alkoxy, and alkyl and alkoxy are         unsubstituted or substituted with one to five substituents         selected from halogen, —OH, —CO₂H, and —SO₃H, and     -   (5) —(CH₂)_(n)heteroaryl, unsubstituted or substituted with one         to five substituents independently selected from —OH, halogen,         —CN, —CO₂H, —SO₃H, C₁₋₆alkyl, and C₁₋₆alkoxy, and alkyl and         alkoxy are unsubstituted or substituted with one to five         substituents selected from halogen, —CO₂H, and —SO₃H;         each R¹⁵ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) —C₁₋₆alkyl,     -   (3) —C₃₋₈cycloalkyl,     -   (4) —SO₂R¹⁴,     -   (5) —COR¹³, and     -   (6) —CO₂R¹⁴,         wherein alkyl and cycloalkyl are unsubstituted or substituted         with one to five substituents selected from halogen, —OH, and         —(CH₂)_(n)CO₂H;         each m is independently 0, 1, 2, or 4; and         each n is independently 0, 1, 2, or 3.

In a further embodiment of the compounds of the present invention, there are provided compounds of formula III:

or a pharmaceutically acceptable salt thereof; wherein R¹, R², R³ and R⁴ are each independently selected from the group consisting of:

-   -   (1) hydrogen,     -   (2) halogen,     -   (3) —OH,     -   (4) —C₁₋₆alkyl, and     -   (5) —C₁₋₆alkoxy,         wherein alkyl and alkoxy are unsubstituted or substituted with         one to five substituents selected from halogen, —OH, C₁₋₆alkyl,         and C₁₋₆alkoxy;         R⁵, R⁶ and R⁷ are each independently selected from the group         consisting of:     -   (1) hydrogen,     -   (2) halogen,     -   (3) —C₁₋₆alkyl, and     -   (4) —C₁₋₆alkoxy,         wherein alkyl and alkoxy are unsubstituted or substituted with         one to five substituents selected from halogen, —OH, C₁₋₆alkyl,         and C₁₋₆alkoxy;         R⁸ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) halogen,     -   (3) —C₁₋₆alkyl,     -   (4) —C₁₋₆alkoxy, and     -   (5) —C₃₋₆cycloalkyl;         each R⁹ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) —CF₃,     -   (3) —OH,     -   (4) —CN,     -   (5) —C₁₋₆alkyl, unsubstituted or substituted with —OH or phenyl,     -   (6) —C₁₋₆alkoxy,     -   (7) —(CH₂)_(n)C₃₋₈cycloalkyl,     -   (8) —(CH₂)_(n)NR¹¹R¹²,     -   (9) -a 5-10 membered aromatic monocyclic or bicyclic         heterocyclic ring, and     -   (10) phenyl, unsubstituted or substituted with one or more         substituents selected from C₁₋₆alkyl, —OH, C₁₋₆alkoxy, —CF₃,         —CN, and halogen;         each R¹⁰ is independently selected from the group consisting of:     -   (1) —C₁₋₆alkyl,     -   (2) -aryl, unsubstituted or substituted with one to five         substituents selected from C₃₋₆alkyl, and alkyl is unsubstituted         or substituted with one to five substituents independently         selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl,     -   (3) -heteroaryl, unsubstituted or substituted with one to five         substituents selected from C₁₋₆alkyl, and alkyl is unsubstituted         or substituted with one to five substituents independently         selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl,     -   (4) —C₂₋₈heterocycloalkyl, unsubstituted or substituted with one         to five substituents selected from C₁₋₆alkyl, and alkyl is         unsubstituted or substituted with one to five substituents         independently selected from halogen, —OH, —SO₃H, —CO₂H, and         —CO₂C₁₋₆alkyl, and     -   (5) —C₃₋₈cycloalkyl, unsubstituted or substituted with one to         five substituents selected from C₁₋₆alkyl, and alkyl is         unsubstituted or substituted with one to five substituents         selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl;         each R¹¹ and R¹² is independently selected from the group         consisting of:     -   (1) hydrogen,     -   (2) —C₁₋₆alkyl, unsubstituted or substituted with one to five         halogens,     -   (3) —(CH₂)_(n)C₃₋₈cycloalkyl, unsubstituted or substituted with         one to five substituents selected from halogen, —OH, and         —(CH₂)_(n)CO₂H, and     -   (4) —(CH₂)_(n) heterocycloalkyl, unsubstituted or substituted         with one to five, substituents independently selected from         halogen, —OH, oxo, C₁₋₆ alkyl, CF₃, and —(CH₂)_(n)CO₂H,         or R¹¹ and R¹² together with the nitrogen to which they are         attached form a 4-8 membered heterocyclic ring containing 0-2         additional heteroatoms selected from oxygen, sulfur, and NR¹⁵,         and wherein the 4-8 membered heterocyclic ring is unsubstituted         or substituted with one to five substituents independently         selected from —OH, oxo, halogen, —CN, —(CH₂)_(n)CO₂H,         —(CH₂)_(n)CO₂C₁₋₆alkyl, —(CH₂)_(n)SO₃H, C₁-C₆alkyl, and         C₁₋₆alkoxy, and alkyl and alkoxy are unsubstituted or         substituted with one to five substituents selected from halogen,         —CO₂H, and —SO₃H;         each R¹³ is independently hydrogen or R¹⁴;         each R¹⁴ is independently selected from the group consisting of:     -   (1) —C₁₋₆alkyl, unsubstituted or substituted with one to five         substituents selected from halogen, —OH, —CO₂H, and —SO₃H,     -   (2) —(CH₂)_(n)C₃₋₈cycloalkyl, unsubstituted or substituted with         one to five substituents selected from halogen, —OH, —CO₂H, and         —SO₃H,     -   (3) —(CH₂)_(n)C₂₋₈heterocycloalkyl, unsubstituted or substituted         with one to five substituents selected from halogen, —OH, oxo,         —C₁₋₆alkyl, C₁₋₆alkoxy, and —(CH₂)_(n)CO₂H, and alkyl and alkoxy         are unsubstituted or substituted with one to five halogens,     -   (6) —(CH₂)_(n)aryl, unsubstituted or substituted with one to         five substituents selected from —OH, halogen, —CN, —CO₂H, —SO₃H,         C₁-C₆alkyl, and C₁₋₆alkoxy, and alkyl and alkoxy are         unsubstituted or substituted with one to five substituents         selected from halogen, —OH, —CO₂H, and —SO₃H, and     -   (7) —(CH₂)_(n)heteroaryl, unsubstituted or substituted with one         to five substituents independently selected from —OH, halogen,         —CN, —CO₂H, —SO₃H, C₁₋₆alkyl, and C₁₋₆alkoxy, and alkyl and         alkoxy are unsubstituted or substituted with one to five         substituents selected from halogen, —CO₂H, and —SO₃H;         each R¹⁵ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) —C₁₋₆alkyl,     -   (3) —C₃₋₈cycloalkyl,     -   (4) —SO₂R¹⁴,     -   (5) —COR¹³, and     -   (6) —CO₂R¹⁴,         wherein alkyl and cycloalkyl are unsubstituted or substituted         with one to five substituents selected from halogen, —OH, and         —(CH₂)_(n)CO₂H;         each R¹⁶ is independently selected from the group consisting of:     -   (1) hydrogen,     -   (2) —CF₃,     -   (3) —OH,     -   (4) —CN,     -   (5) —C₁₋₆alkyl,     -   (6) —C₁₋₆alkoxy,     -   (7) —(CH₂)_(n)C₃₋₈cycloalkyl,     -   (8) —(CH₂)_(n)NR¹¹R¹²,     -   (9) -a 5-10 membered aromatic monocyclic or bicyclic         heterocyclic ring, and     -   (10) phenyl,         wherein alkyl and alkoxy are unsubstituted or substituted with         —OH or phenyl, and wherein cycloalkyl, the heterocyclic ring and         phenyl are unsubstituted or substituted with one or more         substituents selected from C₁₋₆alkyl, —OH, C₁₋₆alkoxy, —CF₃,         —CN, and halogen;         each m is independently 0, 1, 2, 3 or 4; and         each n is independently 0, 1, 2, or 3.

In one class of the embodiments X is N or CR¹⁶. In a subclass of this class, X is N. In another subclass of this class, X is CR¹⁶. In a subclass of this subclass, X is CH. In another subclass of this subclass, X is COH.

In another class of the embodiments, R¹, R², R³ and R⁴ are each independently selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents independently selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, and R² and R³ or R³ and R⁴ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R¹⁵, and wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy.

In another class of the embodiments, R¹, R², R³ and R⁴ are each independently selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents independently selected from halogen, OH, C₁₋₆alkyl, and C₁₋₆alkoxy, or R² and R³ or R³ and R⁴ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R¹⁵, and wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy.

In another class of the embodiments, R¹ is selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy. In a subclass of this class, R¹ is selected from the group consisting of: hydrogen, halogen, —C₁₋₆alkyl optionally substituted with fluoride, —OC₁₋₆alkyl optionally substituted with fluoride, hydroxy, and halogen. In another subclass of this class, R¹ is selected from hydrogen, halogen, and —OCH₃. In another subclass of this class, R¹ is hydrogen, fluoride or —OCH₃. In another subclass of this class, R¹ is hydrogen or —OCH₃. In another subclass of this class, R¹ is hydrogen.

In another class of the embodiments, R² is selected from the group consisting of: hydrogen, —OH, halogen, —C₁₋₆alkyl optionally substituted with fluoride, and —OC₁₋₁₆alkyl optionally substituted with fluoride. In a subclass of this class, R² is selected from hydrogen, —OH, —OCH₃, OCH₂CH₃, —O(CH)(CH₃)₂, —CH₂CH₃, —OCH₂CF₃, and fluoride. In another subclass of this subclass, R² is selected from hydrogen, —OCH₃, —OCH₂CH₃, —OH, —O(CH)(CH₃)₂, and —CH₂CH₃.

In another class of the embodiments, R³ is selected from the group consisting of: hydrogen, —OH, halogen, —C₁₋₆alkyl optionally substituted with fluoride, and —OC₁₋₆alkyl optionally substituted with fluoride. In a subclass of this class, R³ is selected from hydrogen, halogen, and —OCH₃. In another subclass of this class, R³ is hydrogen or —OCH₃. In another subclass of this class, R³ is hydrogen.

In another class of the embodiments, R⁴ is selected from the group consisting of: hydrogen, —OH, halogen, —C₁₋₆alkyl optionally substituted with fluoride, and —OC₁₋₆alkyl optionally substituted with fluoride. In a subclass of this class, R⁴ is selected from hydrogen, —OCH₃, —OCH₂CH₃, —OH, —O(CH)(CH₃)₂, —CH₂CH₃, —OCH₂CF₃, and fluoride. In another subclass of this class, R⁴ is selected from hydrogen, —OCH₃, —OCH₂CH₃, and fluoride. In another subclass of this class, R⁴ is hydrogen, —OCH₂CH₃, or fluoride. In yet another subclass of this class, R⁴ is hydrogen.

In another class of the embodiments, R² and R³ are each independently selected from the group consisting of: OH, C₁₋₆alkyl, and C₁₋₆alkoxy wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and —C₁₋₆alkoxy, or R² and R³ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R⁵, wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from the group consisting of: OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy. In another class of the embodiments, R² and R³ are each independently selected from the group consisting of: —C₁₋₆alkoxy unsubstituted or substituted with one to five substituents selected from halogen; —OH; C₁₋₆alkyl; and C₁₋₆alkoxy; and —C₁₋₆alkoxy, or R² and R³ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R⁵, wherein the ring is unsubstituted or substituted with a substituent selected from the group consisting of: OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy.

In another class of the embodiments, R³ and R⁴ are each independently selected from the group consisting of: OH, C₁₋₆alkyl, and C₁₋₆alkoxy wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen; OH, C₁₋₆alkyl, and —C₁₋₆alkoxy, or R³ and R⁴ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R¹⁵, wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from the group consisting of: OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy. In another class of the embodiments, R³ and R⁴ are each independently selected from the group consisting of: —C₁₋₆alkoxy unsubstituted or substituted with one to five substituents selected from halogen; —OH; C₁₋₆alkyl; and C₁₋₆alkoxy; and —C₁₋₆alkoxy, or R³ and R⁴ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R⁵, wherein the ring is unsubstituted or substituted with a substituent selected from the group consisting of: OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy.

In another class of the embodiments, R¹ and R² are each independently selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, and R³ and R⁴ are each independently selected from the group consisting of: —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, or R³ and R⁴ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R¹⁵, wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy; and pharmaceutically acceptable salts thereof. In a subclass of this class, R¹ and R² are hydrogen. In another subclass of this class, R¹ and R² are hydrogen, and R³ and R⁴ form a ring selected from dioxane, piperidine, pyrrolidine, tetrahydropyran, dihydropyran, dihydrofuran, tetrahydrofuran, and dioxolane. In another subclass of this class, R¹ and R² are hydrogen, and R³ and R⁴ form a 1,4-dioxane ring, a 1,3-dioxolane ring, a tetrahydropyran ring, or a pyrrolidine ring. In another subclass of this class, R¹ and R² are hydrogen, and R³ and R³ form a 1,4-dioxane ring.

In another class of the embodiments, R¹ and R⁴ are each independently selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, and alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, and wherein R² and R³ are each independently selected from the group consisting of: —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, and alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, and R² and R³ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R¹⁵, wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy; and pharmaceutically acceptable salts thereof. In a subclass of this class, R¹ and R⁴ are hydrogen. In another subclass of this class, R¹ and R⁴ are hydrogen, and R² and R³ form a ring selected from dioxane, piperidine, pyrrolidine, tetrahydropyran, dihydropyran, dihydrofuran, tetrahydrofuran, and dioxolane. In another subclass of this class, R¹ and R⁴ are hydrogen, and R² and R³ form a 1,4-dioxane ring, a 1,3-dioxolane ring, a tetrahydropyran ring, or a pyrrolidine ring. In another subclass of this class, R¹ and R⁴ are hydrogen, and R² and R³ form a 1,4-dioxane ring.

In another class of the embodiments, R⁵, R⁶ and R⁷ are each independently selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents independently selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, or R⁵ and R⁶ or R⁶ and R⁷ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R¹⁵, and wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy.

In another class of the embodiments, R⁵, R⁶ and R⁷ are each independently selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents independently selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, or R⁵ and R⁶ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R¹⁵, and wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy.

In another class of the embodiments, R⁵ is selected from the group consisting of: hydrogen, —OH, halogen, —C₁₋₆alkyl optionally substituted with fluoride, and —OC₁₋₆alkyl optionally substituted with fluoride. In a subclass of this class, R⁵ is selected from hydrogen and fluoride. In a subclass of this class, R⁵ is hydrogen. In another subclass of this class, R⁵ is fluoride.

In another class of the embodiments, R⁶ is selected from the group consisting of: hydrogen, —OH, halogen, —C₁₋₆alkyl optionally substituted with fluoride, and —OC₁₋₆alkyl optionally substituted with fluoride. In a subclass of this class, R⁶ is selected from hydrogen, —OCH₃, —OH, —CH₃, —O(CH)(CH₃)₂, —CH₂CH₃, —CF₃, chloride and fluoride. In another subclass of this class, R⁶ is selected from hydrogen, —OCH₃, —CH₃, —CH₂CH₃, —CF₃, chloride and fluoride.

In another class of the embodiments, R⁷ is selected from the group consisting of: hydrogen, halogen, —C₁₋₆alkyl optionally substituted with fluoride, —OC₁₋₆alkyl optionally substituted with fluoride, hydroxy, and halogen. In a subclass of this class, R⁷ is selected from hydrogen, and fluoride. In another subclass of this class, R⁷ is hydrogen. In another subclass of this class, R⁷ is fluoride.

In another class of the embodiments, R⁵ is selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, and wherein R⁶ and R⁷ are each independently selected from the group consisting of: —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, or R⁶ and R⁷ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R¹⁵, wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy; and pharmaceutically acceptable salts thereof. In a subclass of this class, R⁵ is hydrogen. In another subclass of this class, R⁵ is hydrogen, and R⁶ and R⁷ form a ring selected from dioxane, piperidine, pyrrolidine, tetrahydropyran, dihydropyran, dihydrofuran, tetrahydrofuran, and dioxolane. In another subclass of this class, R⁵ is hydrogen, and R⁶ and R⁷ form a 1,4-dioxane ring, a 1,3-dioxolane ring, a tetrahydropyran ring, or a pyrrolidine ring. In another subclass of this class, R⁵ is hydrogen, and R⁶ and R⁷ form a 1,4-dioxane ring.

In another class of the embodiments, R⁷ is selected from the group consisting of: hydrogen, halogen, —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, and R⁵ and R⁶ are each independently selected from the group consisting of: —OH, —C₁₋₆alkyl, and —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy, or R⁵ and R⁶ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms independently selected from oxygen, sulfur, and N—R⁵, wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy; and pharmaceutically acceptable salts thereof. In a subclass of this class, R⁷ is hydrogen. In another subclass of this class, R⁷ is hydrogen, and R⁵ and R⁶ form a ring selected from dioxane, piperidine, pyrrolidine, tetrahydropyran, dihydropyran, dihydrofuran, tetrahydrofuran, and dioxolane. In another subclass of this class, R⁷ is hydrogen, and R⁵ and R⁶ form a 1,4-dioxane ring, a 1,3-dioxolane ring, a tetrahydropyran ring, or a pyrrolidine ring. In another subclass of this class, R⁷ is hydrogen, and R⁵ and R⁶ form a 1,4-dioxane ring.

In another class of the embodiments, R⁸ is independently selected from the group consisting of: hydrogen, halogen, —C₁₋₆alkyl, —C₁₋₆alkoxy, and —C₃₋₆cycloalkyl, wherein alkyl, alkoxy and cycloalkyl are unsubstituted or substituted with one to five substituents selected from halogen and —OH. In a subclass of this class, R⁸ is hydrogen. In another subclass of this class, R⁸ is C₁₋₆alkyl. In another subclass of this class, R⁵ is independently selected from the group consisting of: halogen and —C₁₋₆ alkoxy. In another subclass of this class, R⁸ is halogen. In a subclass of this subclass, R⁸ is independently selected from the group consisting of: bromide, chloride, fluoride and iodide. In another subclass of this subclass, R⁸ is bromide.

In another class of the embodiments, each R⁹ is independently selected from the group consisting of: hydrogen, —CF₃, —OH, —CN, —C₁₋₆alkyl, —C₁₋₆alkoxy, —(CH₂)_(n)C₃₋₈cycloalkyl, —(CH₂)_(n)NR¹¹R¹², -a 5-10 membered aromatic monocyclic or bicyclic heterocyclic ring, and phenyl, wherein alkyl and alkoxy are unsubstituted or substituted with —OH or phenyl, and wherein the heterocyclic ring and phenyl are unsubstituted or substituted with one or more substituents selected from C₁₋₆alkyl, —OH, C₁₋₆alkoxy, —CF₃, —CN, and halogen. In a subclass of this class, each R⁹ is hydrogen. In another subclass of this class, one R⁹ is hydrogen and one R⁹ is C₁₋₆alkyl. In another subclass of this class, each R⁹ is independently selected from the group consisting of: —CF₃; —OH; —CN; —C₁₋₆alkyl substituted with hydroxyl or phenyl; —C₁₋₆alkoxy; —(CH₂)_(n)NR¹¹R¹²; and phenyl substituted with one or more substituents selected from the group consisting of: C₁₋₆alkyl, —OH, C₁₋₆alkoxy, —CF₃, —CN, and halogen. In a subclass of this class, R⁹ is C₁₋₁₆alkyl substituted with hydroxyl or phenyl.

In another class of the embodiments, each R¹⁰ is independently selected from the group consisting of: —C₁₋₆alkyl, -aryl, -heteroaryl, —C₂₋₈heterocycloalkyl, and —C₃₋₈cycloalkyl, and wherein alkyl is unsubstituted, and aryl, heteroaryl, heterocycloalkyl, and C₃₋₈cycloalkyl are unsubstituted or substituted with one to five substituents independently selected from C₁₋₆alkyl.

In a subclass of this class, each R¹⁰ is independently selected from the group consisting of —C₁₋₆alkyl. In another subclass of this class, each R¹⁰ is independently selected from the group consisting of: (1) —C₁₋₆alkyl, unsubstituted, (2) -aryl, unsubstituted or substituted with one to five substituents selected from C₁₋₆alkyl, (3) -heteroaryl, unsubstituted or substituted with one to five substituents selected from C₁₋₆alkyl, (4) —C₂₋₈heterocycloalkyl, unsubstituted or substituted with one to five substituents selected from C₁₋₆alkyl, and (5) —C₃₋₈cycloalkyl, unsubstituted or substituted with one to five substituents selected from C₁₋₆alkyl.

In another class of the embodiments, each R¹⁰ is independently selected from the group consisting of: (1) -aryl, substituted with one to five substituents selected from C₁₋₆alkyl, and alkyl is substituted with one to five substituents independently selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl, (2) -heteroaryl, substituted with one to five substituents selected from C₁₋₆alkyl, and alkyl is substituted with one to five substituents independently selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl, (3) —C₂₋₈heterocycloalkyl, substituted with one to five substituents selected from C₁₋₆alkyl, and alkyl is substituted with one to five substituents independently selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl, and (4) —C₃₋₈cycloalkyl, substituted with one to five substituents selected from C₁₋₆alkyl, and alkyl is substituted with one to five substituents selected from halogen, —OH, —SO₃H, —CO₂H, and —CO₂C₁₋₆alkyl.

In another class of the embodiments, each R¹¹ and R¹² is independently selected from the group consisting of: hydrogen, —C₁₋₆alkyl, —(CH₂)_(n)C₃₋₈cycloalkyl, and —(CH₂)_(n) heterocycloalkyl, or R¹¹ and R¹² together with the nitrogen to which they are attached form a 4-8 membered heterocyclic ring containing 0-2 additional heteroatoms selected from oxygen, sulfur, and NR¹⁵, and wherein alkyl, cycloalkyl, heterocycloalkyl and the 4-8 membered heterocyclic ring are unsubstituted or substituted with one to five substituents independently selected from halogen, —OH, oxo, —CN, CF₃, C₁-C₆alkyl, C₁₋₆alkoxy, —(CH₂)_(n)CO₂H, —(CH₂)_(n)CO₂C₁₋₆alkyl, and —(CH₂)_(n)SO₃H, and alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —CO₂H, and —SO₃H.

In a subclass of this class, each R¹¹ and R¹² is independently selected from the group consisting of: hydrogen, —C₁₋₆alkyl, unsubstituted or substituted with one to five halogens, —(CH₂)_(n)C₃₋₈cycloalkyl, unsubstituted or substituted with one to five substituents selected from halogen, —OH, and —(CH₂)_(n)CO₂H, and —(CH₂)_(n) heterocycloalkyl, unsubstituted or substituted with one to five substituents selected from halogen, —OH, oxo, C₁₋₆ alkyl, CF₃, and —(CH₂)_(n)CO₂H, or R¹¹ and R¹² together with the nitrogen to which they are attached form a 4-8 membered heterocyclic ring containing 0-2 additional heteroatoms selected from oxygen, sulfur, and NR¹⁵, and wherein the 4-8 membered heterocyclic ring is unsubstituted or substituted with one to five substituents independently selected from —OH, oxo, halogen, —CN, —(CH₂)_(n)CO₂H, —(CH₂)_(n)CO₂C₁₋₆alkyl, —(CH₂)_(n)SO₃H, C₁-C₆alkyl, and C₁₋₆alkoxy, and alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —CO₂H, and —SO₃H.

In another class of the embodiments, each R¹³ is independently hydrogen or R¹⁴. In a subclass of this class, R¹³ is hydrogen. In another subclass of this class, R¹³ is R¹⁴.

In another class of the embodiments, each R¹⁴ is independently selected from the group consisting of: —C₁₋₆alkyl, —(CH₂)_(n)C₃₋₈cycloalkyl, —(CH₂)_(n)C₂₋₈ heterocycloalkyl, —(CH₂)_(n)aryl, and —(CH₂)_(n)heteroaryl, wherein alkyl, cycloalkyl, heterocycloalkyl, aryl and heteroaryl are unsubstituted or substituted with one to five substituents independently selected from —OH, oxo, halogen, —CN, —(CH₂)_(n)CO₂H, —SO₃H, C₁₋₆alkyl, and C₁₋₆alkoxy, and alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, —CO₂H, and —SO₃H.

In another class of the embodiments, each R¹⁴ is independently selected from the group consisting of: —C₁₋₆alkyl, unsubstituted or substituted with one to five substituents selected from halogen, —OH, —CO₂H, and —SO₃H, —(CH₂)_(n)C₃₋₈cycloalkyl, unsubstituted or substituted with one to five substituents selected from halogen, —OH, —CO₂H, and —SO₃H, —(CH₂)_(n)C₂₋₈heterocycloalkyl, unsubstituted or substituted with one to five substituents selected from halogen, —OH, oxo, —C₁₋₆alkyl, C₁₋₆alkoxy, and —(CH₂)_(n)CO₂H, and alkyl and alkoxy are unsubstituted or substituted with one to five halogens, —(CH₂)_(n)aryl, unsubstituted or substituted with one to five substituents selected from —OH, halogen, —CN, —CO₂H, —SO₃H, C₁-C₆alkyl, and C₁₋₆alkoxy, and alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, —CO₂H, and —SO₃H, and —(CH₂)_(n)heteroaryl, unsubstituted or substituted with one to five substituents independently selected from —OH, halogen, —CN, —CO₂H, —SO₃H, C₁₋₆alkyl, and C₁₋₆alkoxy, and alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —CO₂H, and —SO₃H.

In another class of the embodiments, each R¹⁴ is independently selected from the group consisting of: —(CH₂)_(n)C₃₋₈cycloalkyl, unsubstituted or substituted with one to five substituents selected from the group consisting of: halogen, hydrogen, —OH, —CO₂H, and —SO₃H; and —(CH₂)_(n)C₂₋₈ heterocycloalkyl, unsubstituted or substituted with one to five substituents selected from the group consisting of: halogen, —OH, oxo, —C₁₋₆alkyl, C₁₋₆alkoxy, and —CH₂)_(n)CO₂H, and wherein alkyl and alkoxy are unsubstituted or substituted with one to five halogens.

In another class of the embodiments, each R¹⁵ is independently selected from the group consisting of: hydrogen, —C₁₋₆alkyl, —C₃₋₈cycloalkyl, —SO₂R¹⁴, —COR¹³, and —CO₂R¹⁴, wherein alkyl and cycloalkyl are unsubstituted or substituted with one to five substituents selected from halogen, —OH, and —(CH₂)_(n)CO₂H.

In another class of the embodiments, each R¹⁶ is independently selected from the group consisting of: hydrogen, —CF₃, —OH, —CN, —C₁₋₆alkyl, —C₁₋₆alkoxy, —(CH₂)_(n)C₃₋₈cycloalkyl, —(CH₂)_(n)NR¹¹R¹², -a 5-10 membered aromatic monocyclic or bicyclic heterocyclic ring, and phenyl, wherein alkyl and alkoxy are unsubstituted or substituted with —OH or phenyl, and wherein cycloalkyl, the heterocyclic ring and phenyl are unsubstituted or substituted with one or more substituents selected from C₁₋₆alkyl, —OH, C₁₋₆alkoxy, —CF₃, —CN, and halogen. In a subclass of this class, each R¹⁶ is independently selected from the group consisting of: hydrogen, —OH and —C₁₋₆alkyl. In another subclass of this class, R¹⁶ is hydrogen. In another subclass of this class, R¹⁶ is —OH.

In another class of the embodiments, each m is independently 0, 1, 2, 3 or 4. In a subclass of this class, m is 0, 1, or 2. In another subclass of this class, m is 0. In another subclass of this class, m is 1. In another subclass of this class, m is 2.

In another class of the embodiments, each n is independently 0, 1, 2, or 3. In a subclass of this class, n is 0, 1, or 2. In another subclass of this class, n is 0. In another subclass of this class, n is 1. In another subclass of this class, n is 2.

In another class of the embodiment, each p is independently 0, 1, 2, 3 or 4. In a subclass of this class, p is 0, 1 or 2. In another subclass of this class, p is 0. In another subclass of this class, p is 1. In yet another subclass of this class, p is 2.

In another embodiment, the compound of formula I is selected from:

-   (1)     1-{[2-(2,4-difluorophenyl)-1-(3-ethoxyphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (2)     1-{[1-(3-methoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (3)     1-{[1-(3-ethoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (4)     1-{[1-(3-hydroxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (5)     1-{[1-(2,3-dimethoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (6)     1-{[1-(3-isopropoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (7)     1-{[1-(3-ethylphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (8)     1-{[1-(4-methoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (9)     1-{[1-(3-ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (10)     1-{[1-(3-ethoxyphenyl)-2-phenyl-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (11)     1-{[1-(3-ethoxyphenyl)-2-(4-chlorophenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (12)     1-{[1-(3-ethoxyphenyl)-2-(2-fluorophenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (13)     1-{[1-(3-ethoxyphenyl)-2-(4-ethylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (14)     1-{[1-(3-ethoxyphenyl)-2-(4-methoxyphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (15)     1-{[1-(3-ethoxyphenyl)-2-(4-trifluoromethylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (16)     1-{[1-(3-ethoxy-5-fluorophenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (17)     1-{[1-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, -   (18)     1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, -   (19)     1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, -   (20)     1-{[1-(1,3-benzodioxol-5-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, -   (21)     1-{[1-(3,4-dihydro-2H-chromen-6-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine,     and -   (22)     5-(2-(4-methylphenyl)-4-{[4-(2-naphthyl)-1-piperazinyl]carbonyl}-1H-imidazol-1-yl)indoline;     or a pharmaceutically acceptable salt thereof.

In a class of this embodiment, the compound of formula I is selected from:

-   (1)     1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, -   (2)     1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, -   (3)     1-{[1-(1,3-benzodioxol-5-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, -   (4)     1-{[1-(3,4-dihydro-2H-chromen-6-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine,     and -   (5)     5-(2-(4-methylphenyl)-4-{[4-(2-naphthyl)-1-piperazinyl]carbonyl}-1H-imidazol-1-yl)indoline;     or a pharmaceutically acceptable salt thereof.

In a subclass of this class, the compound of formula I is selected from: 1-{[2-(2,4-difluorophenyl)-1-(3-ethoxyphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; or a pharmaceutically acceptable salt thereof. In another subclass of this class, the compound of formula I is selected from 1-{[1-(3-methoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; or a pharmaceutically acceptable salt thereof. In another subclass of this class, the compound of formula I is selected from 1-{[1-(3-ethoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; or a pharmaceutically acceptable salt thereof. In another subclass of this class, the compound of formula I is selected from 1-{[1-(3-ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; or a pharmaceutically acceptable salt thereof. In another subclass of this class, the compound of formula I is selected from 1-{[1-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; or a pharmaceutically acceptable salt thereof.

In another class of the embodiments, the pharmaceutically acceptable salt is a trifluoroacetic acid salt. In another class of the embodiments, the pharmaceutically acceptable salt is a hydrochloric acid salt.

The compounds of formula I, II, and III are effective as cholecystokinin receptor ligands and are particularly effective as selective ligands of the cholecystokinin-1 receptor. They are therefore useful for the treatment and/or prevention of disorders responsive to the modulation of the cholecystokinin-1 receptor, such as obesity, diabetes, and obesity-related disorders. More particularly, the compounds of formula I, II, and III are selective cholecystokinin-1 receptor (CCK-1R) agonists useful for the treatment of disorders responsive to the activation of the cholecystokinin-1 receptor, such as obesity, diabetes, as well as the treatment of gallstones.

One aspect of the present invention provides a method for the treatment or prevention of disorders, diseases or conditions responsive to the modulation of the cholecystokinin-1 receptor in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof.

Another aspect of the present invention provides a method for the treatment or prevention of obesity, diabetes, or an obesity related disorder in a subject in need thereof which comprises administering to said subject a therapeutically or prophylactically effective amount of a cholecystokinin-1 receptor agonist of the present invention. Another aspect of the present invention provides a method for the treatment or prevention of obesity in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof. Another aspect of the present invention provides a method for reducing food intake in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof. Another aspect of the present invention provides a method for increasing satiety in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof. Another aspect of the present invention provides a method for reducing appetite in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof. Another aspect of the present invention provides a method for reducing gastric emptying in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof. Another aspect of the present invention provides a method for the treatment or prevention of bulimia nervosa in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof.

Another aspect of the present invention provides a method for the treatment or prevention of diabetes mellitus in a subject in need thereof comprising administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof. Another aspect of the present invention provides a method for the treatment or prevention of dyslipidemia in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof. Another aspect of the present invention provides a method for the treatment or prevention of tardive dyskinesia in a subject in need thereof which comprises administering to said subject a therapeutically or prophylactically effective amount of a cholecystokinin-1 receptor agonist of the present invention.

Another aspect of the present invention provides a method for the treatment or prevention of an obesity-related disorder selected from the group consisting of overeating, binge eating, hypertension, elevated plasma insulin concentrations, insulin resistance, hyperlipidemia, endometrial cancer, breast cancer, prostate cancer, colon cancer, kidney cancer, osteoarthritis, obstructive sleep apnea, heart disease, abnormal heart rhythms and arrythmias, myocardial infarction, congestive heart failure, coronary heart disease, sudden death, stroke, polycystic ovary disease, craniopharyngioma, metabolic syndrome, insulin resistance syndrome, sexual and reproductive dysfunction, infertility, hypogonadism, hirsutism, obesity-related gastro-esophageal reflux, Pickwickian syndrome, inflammation, systemic inflammation of the vasculature, arteriosclerosis, hypercholesterolemia, hyperuricaemia, lower back pain, gallbladder disease, gout, constipation, irritable bowel syndrome, inflammatory bowel syndrome, cardiac hypertrophy, left ventricular hypertrophy, in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof.

Another aspect of the present invention provides a method for the treatment or prevention of cognitive and memory deficiency, including the treatment of Alzheimer's disease, in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof.

Another aspect of the present invention provides a method for the treatment or prevention of pain in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof.

Another aspect of the present invention provides a method for the treatment or prevention of cholelithiasis (gallstones) in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof.

Another aspect of the present invention provides a method for the treatment or prevention of cholecystitis (inflammation of the gallbladder) in a subject in need thereof which comprises administering to the subject a therapeutically or prophylactically effective amount of a compound of formula I, II or III, or a pharmaceutically acceptable salt thereof.

The present invention also relates to methods for treating or preventing obesity by administering a cholecystokinin-1 receptor agonist of the present invention in combination with a therapeutically or prophylactically effective amount of another agent known to be useful to treat or prevent the condition. The present invention also relates to methods for treating or preventing diabetes by administering the cholecystokinin-1 receptor agonist of the present invention in combination with a therapeutically or prophylactically effective amount of another agent known to be useful to treat or prevent the condition. The present invention also relates to methods for treating or preventing obesity related disorders by administering the cholecystokinin-1 receptor agonist of the present invention in combination with a therapeutically or prophylactically effective amount of another agent known to be useful to treat or prevent the condition.

Another aspect of the present invention provides a pharmaceutical composition comprising a compound of formula I, II, or III and a pharmaceutically acceptable carrier.

Yet another aspect of the present invention relates to the use of a compound of formula I, II, or III for the manufacture of a medicament useful for the treatment or prevention, or suppression of a disease mediated by the cholecystokinin-1 receptor in a subject in need thereof.

Yet another aspect of the present invention relates to the use of a cholecystokinin-1 agonist of the present invention for the manufacture of a medicament useful for the treatment or prevention, or suppression of a disease mediated by the cholecystokinin-1 receptor, wherein the disease is selected from the group consisting of obesity, diabetes and an obesity-related disorder in a subject in need thereof.

Yet another aspect of the present invention relates to the use of a cholecystokinin-1 agonist of the present invention for the manufacture of a medicament useful for the treatment or prevention of gallstones in a subject in need thereof. Yet another aspect of the present invention relates to the use of a cholecystokinin-1 agonist of the present invention for the manufacture of a medicament useful for the treatment or prevention of dyslipidemia in a subject in need thereof. Yet another aspect of the present invention relates to the use of a cholecystokinin-1 agonist of the present invention for the manufacture of a medicament useful for the treatment or prevention of bulimia nervosa in a subject in need thereof. Yet another aspect of the present invention relates to the use of a cholecystokinin-1 agonist of the present invention for the manufacture of a medicament useful for the treatment or prevention of constipation in a subject in need thereof. Yet another aspect of the present invention relates to the use of a cholecystokinin-1 agonist of the present invention for the manufacture of a medicament useful for the treatment or prevention of irritable bowel syndrome in a subject in need thereof.

Yet another aspect of the present invention relates to the use of a therapeutically effective amount of a cholecystokinin-1 receptor agonist of formula I, II, or III, or a pharmaceutically acceptable salt thereof, and a therapeutically effective amount of an agent selected from the group consisting of an insulin sensitizer, an insulin mimetic, a sulfonylurea, an α-glucosidase inhibitor, a dipeptidyl peptidase 4 (DPP-4 or DP-IV) inhibitor, a glucagons like peptide 1 (GLP-1) agonist, a HMG-CoA reductase inhibitor, a serotonergic agent, a β3-adrenoreceptor agonist, a neuropeptide Y1 antagonist, a neuropeptide Y2 agonist, a neuropeptide Y5 antagonist, a pancreatic lipase inhibitor, a cannabinoid CB₁ receptor antagonist or inverse agonist, a melanin-concentrating hormone receptor antagonist, a melanocortin 4 receptor agonist, a bombesin receptor subtype 3 agonist, a ghrelin receptor antagonist, PYY, PYY₃₋₃₆, and a NK-1 antagonist, or a pharmaceutically acceptable salt thereof, for the manufacture of a medicament useful for the treatment, control, or prevention of obesity, diabetes or an obesity-related disorder in a subject in need of such treatment. Yet another aspect of the present invention relates to the use of a therapeutically effective amount of a cholecystokinin-1 receptor agonist of formula I, II, or III, and pharmaceutically acceptable salts and esters thereof, and a therapeutically effective amount of an agent selected from the group consisting of an insulin sensitizer, an insulin mimetic, a sulfonylurea, an α-glucosidase inhibitor, a dipeptydyl peptidase 4 inhibitor, a glucagon-like peptide 1 agonist, a HMG-CoA reductase inhibitor, a serotonergic agent, a β3-adrenoreceptor agonist, a neuropeptide Y1 antagonist, a neuropeptide Y2 agonist, a neuropeptide Y5 antagonist, a pancreatic lipase inhibitor, a cannabinoid CB₁ receptor antagonist or inverse agonist, a melanin-concentrating hormone receptor antagonist, a melanocortin 4 receptor agonist, a bombesin receptor subtype 3 agonist, a ghrelin receptor antagonist, PYY, PYY₃₋₃₆, and a NK-1 antagonist, or a pharmaceutically acceptable salt thereof, for the manufacture of a medicament for treatment or prevention of obesity, diabetes or an obesity-related disorder which comprises an effective amount of a cholecystokinin-1 receptor agonist of formula I, II, or III and an effective amount of the agent, together or separately. Yet another aspect of the present invention relates to a product containing a therapeutically effective amount of a cholecystokinin-1 receptor agonist of formula I, II, or III, or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of an agent selected from the group consisting of an insulin sensitizer, an insulin mimetic, a sulfonylurea, an α-glucosidase inhibitor, a HMG-CoA reductase inhibitor, a serotonergic agent, a β3-adrenoreceptor agonist, a neuropeptide Y1 antagonist, a neuropeptide Y2 agonist, a neuropeptide Y5 antagonist, a pancreatic lipase inhibitor, a cannabinoid CB₁ receptor antagonist or inverse agonist, a melanocortin 4 receptor agonist, a melanin-concentrating hormone receptor antagonist, a bombesin receptor subtype 3 agonist, a ghrelin receptor antagonist, PYY, PYY₃₋₃₆, and a NK-1 antagonist, or a pharmaceutically acceptable salt thereof, as a combined preparation for simultaneous, separate or sequential use in obesity, diabetes, or an obesity-related disorder.

The compounds of formula I, II, and III can be provided in kit. Such a kit typically contains an active compound in dosage forms for administration. A dosage form contains a sufficient amount of active compound such that a beneficial effect can be obtained when administered to a patient during regular intervals, such as 1, 2, 3, 4, 5 or 6 times a day, during the course of 1 or more days. Preferably, a kit contains instructions indicating the use of the dosage form for weight reduction (e.g., to treat obesity) and the amount of dosage form to be taken over a specified time period.

Throughout the instant application, the following terms have the indicated meanings:

The term “alkyl”, as well as other groups and substituents having the prefix “alk”, such as alkoxy, alkanoyl, means carbon chains of the designated length which may be in a straight or branched configuration, or combinations thereof. Examples of alkyl groups and substituents include methyl, ethyl, n-propyl, isopropyl, n-butyl, 1-methylpropyl, 2-methylpropyl, tert-butyl, n-pentyl, 1-methylbutyl, 2-methylbutyl, 3-methylbutyl, 1,2-dimethylpropyl, 1,1-dimethylpropyl, 2,2-dimethylpropyl, n-hexyl, 1-methylpentyl, 2-methylpentyl, 3-methylpentyl, 4-methylpentyl, 1-ethylbutyl, 2-ethylbutyl, 3-ethylbutyl, 1,1-dimethyl butyl, 1,2-dimethylbutyl, 1,3-dimethylbutyl, 2,2-dimethylbutyl, 2,3-dimethylbutyl, 3,3-dimethyl butyl, n-heptyl, 1-methylhexyl, 2-methylhexyl, 3-methylhexyl, 4-methylhexyl, 5-methylhexyl, 1-ethylpentyl, 2-ethylpentyl, 3-ethylpentyl, 4-ethylpentyl, 1-propylbutyl, 2-propylbutyl, 3-propylbutyl, 1,1-dimethylpentyl, 1,2-dimethylpentyl, 1,3-dimethylpentyl, 1,4-dimethylpentyl, 2,2-dimethylpentyl, 2,3-dimethylpentyl, 2,4-dimethylpentyl, 3,3-dimethylpentyl, 3,4-dimethylpentyl, 4,4-dimethylpentyl, 1-methyl-1-ethylbutyl, 1-methyl-2-ethylbutyl, 2-methyl-2-ethylbutyl, 1-ethyl-2-methylbutyl, 1-ethyl-3-methylbutyl, 1,1-diethylpropyl, n-octyl, n-nonyl, and the like.

The term “alkenyl” means carbon chains which contain at least one carbon-carbon double bond, and which may be linear or branched or combinations thereof. Examples of alkenyl include vinyl, allyl, isopropenyl, pentenyl, hexenyl, heptenyl, 1-propenyl, 2-butenyl, 2-methyl-2-butenyl, and the like.

The term “alkynyl” means carbon chains which contain at least one carbon-carbon triple bond, and which may be linear or branched or combinations thereof. Examples of alkynyl include ethynyl, propargyl, 3-methyl-1-pentynyl, 2-heptynyl and the like.

The term “alkoxy” means alkyl chains of the designated length which contain at least one ether linkage and which may be linear or branched or combinations thereof. Examples of alkoxy include methoxy, ethoxy, 1-propoxy, 2-propoxy, 1-butoxy, 2-butoxy, methylmethoxy, methylethoxy, methyl-1-propoxy, methyl-2-propoxy, ethyl-2-methoxy, ethyl-1-methoxy and the like.

The term “halogen” includes fluorine, chlorine, bromine and iodine.

The term “C₁₋₄ alkyliminoyl” means C₁₋₃C(═NH)—.

The term “aryl” includes mono- or bicyclic aromatic rings containing only carbon atoms. Examples of aryl include phenyl and naphthyl.

The term “heteroaryl” includes mono- and bicyclic aromatic rings containing from 1 to 4 heteroatoms selected from nitrogen, oxygen and sulfur. Examples thereof include, but are not limited to, pyridinyl, furyl, thienyl, pyrrolyl, oxazolyl, thiazolyl, triazolyl, triazinyl, tetrazolyl, thiadiazolyl, imidazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, pyrazolyl, pyrimidinyl, pyrazinyl, pyridazinyl, quinolyl, isoquinolyl, benzimidazolyl, benzofuryl, benzothienyl, indolyl, benzthiazolyl, benzoxazolyl, and the like. In one embodiment of the present invention, heteroaryl is selected from the group consisting of pyridinyl, furyl, thienyl, pyrrolyl, oxazolyl, thiazolyl, triazolyl, triazinyl, tetrazolyl, thiadiazolyl, imidazolyl, pyrazolyl, isoxazolyl, isothiazolyl, oxathiazolyl, pyrimidinyl, pyrazinyl, pyridazinyl, quinolyl, isoquinolyl, benzimidazolyl, benzofuryl, benzothienyl, indolyl, benzthiazolyl, and benzoxazolyl. Bicyclic heteroaromatic rings include, but are not limited to, benzothiadiazole, indole, benzothiophene, benzofuran, benzimidazole, benzisoxazole, benzothiazole, quinoline, quinazoline, benzotriazole, benzoxazole, isoquinoline, purine, furopyridine, thienopyridine, benzisodiazole, triazolopyrimidine, and 5,6,7,8-tetrahydroquinoline.

The term “cycloalkyl” includes mono- or bicyclic non-aromatic rings containing only carbon atoms. Examples of cycloalkyl include, but are not limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl.

The term “heterocycloalkyl” is intended to include non-aromatic heterocycles containing one to four heteroatoms selected from nitrogen, oxygen and sulfur. Examples of heterocycloalkyls include, but are not limited to, azetidine, piperidine, morpholine, thiamorpholine, pyrrolidine, imidazolidine, tetrahydrofuran, piperazine, 1-thia-4-aza-cyclohexane.

The term “5-10 membered aromatic monocyclic or bicyclic heterocyclic ring” means a 5- or 6-membered aromatic heterocyclic ring or a fused bicyclic aromatic ring, which may contain one to three of the heteroatoms selected from nitrogen, oxygen and sulfur, and includes, but is not limited to, furyl, thienyl, isoxazolyl, pyridyl, pyrimidinyl, benzofuranyl, and benzothienyl.

Certain of the above defined terms may occur more than once in the above formula and upon such occurrence each term shall be defined independently of the other; thus for example, NR⁴R⁴ may represent NH₂, NHCH₃, N(CH₃)CH₂CH₃, and the like.

The term “subject” means a mammal. One embodiment of the term “mammal” is a “human,” said human being either male or female. The instant compounds are also useful for treating or preventing obesity and obesity related disorders in cats and dogs. As such, the term “mammal” includes companion animals such as cats and dogs. The term “mammal in need thereof” refers to a mammal who is in need of treatment or prophylaxis as determined by a researcher, veterinarian, medical doctor or other clinician.

The term “composition”, as in pharmaceutical composition, is intended to encompass a product comprising the active ingredient(s), and the inert ingredient(s) that make up the carrier, as well as any product which results, directly or indirectly, from combination, complexation or aggregation of any two or more of the ingredients, or from dissociation of one or more of the ingredients, or from other types of reactions or interactions of one or more of the ingredients. Accordingly, the pharmaceutical compositions of the present invention encompass any composition made by admixing a compound of the present invention and a pharmaceutically acceptable carrier.

By a cholecystokinin receptor “agonist” is meant an endogenous or drug substance or compound that can interact with a cholecystokinin receptor and initiate a pharmacological or biochemical response characteristic of cholecystokinin receptor activation. The “agonistic” properties of the compounds of the present invention were measured in the functional assay described below.

By “binding affinity” is meant the ability of a compound/drug to bind to its biological target, in the present instance, the ability of a compound of formula I, II, or III, to bind to a cholecystokinin receptor. Binding affinities for the compounds of the present invention were measured in the binding assay described below and are expressed as IC₅₀'s.

“Efficacy” describes the relative intensity of response which different agonists produce even when they occupy the same number of receptors and with the same affinity. Efficacy is the property that describes the magnitude of response. Properties of compounds can be categorized into two groups, those which cause them to associate with the receptors (binding affinity) and those that produce a stimulus (efficacy). The term “efficacy” is used to characterize the level of maximal responses induced by agonists. Not all agonists of a receptor are capable of inducing identical levels of maximal responses. Maximal response depends on the efficiency of receptor coupling, that is, from the cascade of events, which, from the binding of the drug to the receptor, leads to the desired biological effect.

The functional activities expressed as EC₅₀'s and the “agonist efficacy” for the compounds of the present invention at a particular concentration were measured in the functional assay described below. The CCK1R active and selective agonists of the present invention have an IC₅₀≦500 nM, preferably IC₅₀<100 nM, more preferably IC₅₀<10 nM, and most preferably IC₅₀<1 nM, while having at least 100-fold and preferably >1000-fold selectivity over CCK2R. The CCK1R active and selective agonists of the present invention have an EC₅₀≦500 nM, preferably EC₅₀<100 nM, more preferably EC₅₀<10 nM, and most preferably EC₅₀<1 nM, while having at least 100-fold, and preferably >1000-fold selectivity over CCK2R. The EC₅₀ for activation of the CCK1F or CCK2R receptor was calculated from the titration curve of the compounds.

Compounds of formula I, I, and III, may contain one or more asymmetric or chiral centers and can exist in different stereoisomeric forms, such as racemates and racemic mixtures, single enantiomers, enantiomeric mixtures, individual diastereomers and diastereomeric mixtures. All stereoisomeric forms of the intermediates and compounds of the present invention as well as mixtures thereof, including racemic and diastereomeric mixtures, which possess properties useful in the treatment of the conditions discussed herein or are intermediates useful in the preparation of compounds having such properties, form a part of the present invention.

Generally, one of the enantiomers will be more active biologically than the other enantiomer. Racemic mixtures can subsequently be separated into each enantiomer using standard conditions, such as resolution or chiral chromatography. Diastereomeric mixtures may be separated into their individual diastereoisomers on the basis of their physical chemical differences by methods well known to those skilled in the art, such as by chiral chromatography using an optically active stationary phase and/or fractional crystallization from a suitable solvent. Absolute stereochemistry may be determined by X-ray crystallography of crystalline products or crystalline intermediates which are derivatized, if necessary, with a reagent containing an asymmetric center of known absolute configuration. Enantiomers may be separated by use of a chiral HPLC column and by converting the enantiomeric mixture into a diastereomeric mixture by reaction with an appropriate optically active compound (e.g., chiral auxiliary such as a chiral alcohol or Mosher's acid chloride), separating the diastereoisomers and converting (e.g., hydrolyzing) the individual diastereoisomers to the corresponding pure enantiomers. Alternatively, any stereoisomer of a compound of the general formula I, II, and III may be obtained by stereospecific synthesis using optically pure starting materials or reagents of known absolute configuration.

The present invention includes all such isomeric forms of the compounds of formula I, II, and III, including the E and Z geometric isomers of double bonds and mixtures thereof. A number of the compounds of the present invention and intermediates therefor exhibit tautomerism and therefore may exist in different tautomeric forms under certain conditions. The term “tautomer” or “tautomeric form” refers to structural isomers of different energies which are interconvertible via a low energy barrier. For example, proton tautomers (also known as prototropic tautomers) include interconversions via migration of a proton, such as keto-enol and imine-enamine isomerizations. A specific example of a proton tautomer is an imidazole moiety where the hydrogen may migrate between the ring nitrogens. Valence tautomers include interconversions by reorganization of some of the bonding electrons. All such tautomeric forms (e.g., all keto-enol and imine-enamine forms) are within the scope of the invention. The depiction of any particular tautomeric form in any of the structural formulas herein is not intended to be limiting with respect to that form, but is meant to be representative of the entire tautomeric set.

The present invention also encompasses isotopically labeled compounds which are identical to the compounds of Formula (I) or intermediates thereof but for the fact that one or more atoms are replaced by an atom having an atomic mass or mass number different from the atomic mass or mass number usually found in nature. Examples of isotopes that can be incorporated into the intermediates or compounds of the invention include isotopes of hydrogen, carbon, nitrogen, oxygen, phosphorus, sulfur, fluorine, iodine, and chlorine, such as 2H, 3H, 11C, 13C, 14C, 13N, 15N, 15O, 17O, 18O, 31P, 32P, 35S, 18F, 123I, 125I and 36Cl, respectively. Compounds of the present invention, prodrugs thereof and pharmaceutically acceptable salts, hydrates and solvates of said compounds and of said prodrugs which contain the aforementioned isotopes and/or other isotopes of other atoms are within the scope of the present invention. Certain isotopically labeled compounds of the present invention (e.g., those labeled with 3H and 14C) are useful in compound and/or substrate tissue distribution assays. Tritiated (i.e., 3H) and carbon-14 (i.e., 14C) isotopes are particularly preferred for their ease of preparation and detectability. Further, substitution with heavier isotopes such as deuterium (i.e., 2H) may afford certain therapeutic advantages resulting from greater metabolic stability (e.g., increased in vivo half-life or reduced dosage requirements) and hence may be preferred in some circumstances. Positron emitting isotopes such as 15O, 13N, 11C, and 18F are useful for positron emission tomography (PET) studies to examine substrate receptor occupancy. Isotopically labeled compounds of the present invention can generally be prepared by following procedures analogous to those disclosed in the Schemes and/or in the Examples herein by substituting an isotopically labeled reagent for a non-isotopically labeled reagent.

The compounds of the present invention and intermediates may exist in unsolvated as well as solvated forms with solvents such as water, ethanol, isopropanol and the like, and both solvated and unsolvated forms are included within the scope of the invention. Solvates for use in the methods aspect of the invention should be with pharmaceutically acceptable solvents. It will be understood that the compounds of the present invention include hydrates, solvates, polymorphs, crystalline, hydrated crystalline and amorphous forms of the compounds of the present invention, and pharmaceutically acceptable salts thereof.

The term “pharmaceutically acceptable salts” refers to salts prepared from pharmaceutically acceptable non-toxic bases or acids including inorganic or organic bases and inorganic or organic acids. Salts derived from inorganic bases include aluminum, ammonium, calcium, copper, ferric, ferrous, lithium, magnesium, manganic salts, manganous, potassium, sodium, zinc, and the like. Particularly preferred are the ammonium, calcium, lithium, magnesium, potassium, and sodium salts. Salts derived from pharmaceutically acceptable organic non-toxic bases include salts of primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines, and basic ion exchange resins, such as arginine, betaine, caffeine, choline, N,N′-dibenzylethylenediamine, diethylamine, 2-diethylaminoethanol, 2-dimethylaminoethanol, ethanolamine, ethylenediamine, N-ethyl-morpholine, N-ethylpiperidine, glucamine, glucosamine, histidine, hydrabamine, isopropylamine, lysine, methylglucamine, morpholine, piperazine, piperidine, polyamine resins, procaine, purines, theobromine, TEA, trimethylamine, tripropylamine, tromethamine, and the like.

When the compounds of formula I, II, and III are basic, salts may be prepared from pharmaceutically acceptable non-toxic acids, including inorganic and organic acids. Such acids include acetic, benzenesulfonic, benzoic, camphorsulfonic, citric, ethanesulfonic, formic, fumaric, gluconic, glutamic, hydrobromic, hydrochloric, isethionic, lactic, maleic, malic, mandelic, methanesulfonic, malonic, mucic, nitric, pamoic, pantothenic, phosphoric, propionic, succinic, sulfuric, tartaric, p-toluenesulfonic acid, trifluoroacetic acid, and the like. Particularly preferred are citric, fumaric, hydrobromic, hydrochloric, maleic, phosphoric, sulfuric, and tartaric acids. It will be understood that, as used herein, references to the compounds of formula I, II, and III are meant to also include the pharmaceutically acceptable salts, such as the hydrochloride salts.

Compounds of formula I, II, and III are cholecystokinin receptor ligands and as such are useful in the treatment, control or prevention of diseases, disorders or conditions responsive to the modulation of one or more of the cholecystokinin receptors. In particular, the compounds of formula I, II, and III act as cholecystokinin-1 receptor agonists useful in the treatment, control or prevention of diseases, disorders or conditions responsive to the activation of the cholecystokinin-1 receptor. Such diseases, disorders or conditions include, but are not limited to, obesity (by reducing food intake, reducing appetite, increasing metabolic rate, increasing satiety, reducing carbohydrate craving, reducing gastric emptying), diabetes mellitus (by enhancing glucose tolerance, decreasing insulin resistance), bulimia nervosa and related eating disorders, dyslipidemia, hypertension, hyperlipidemia, osteoarthritis, cancer, gall stones, cholelithiasis, cholecystitis, gall bladder disease, sleep apnea, depression, anxiety, compulsion, neuroses, irritable bowel syndrome, inflammatory bowel syndrome, constipation, pain, neuroprotective and cognitive and memory enhancement including the treatment of Alzheimer's disease. Such diseases, conditions and disorders also include non-obese overweight conditions and normal weight conditions where weight control or management is desired in order to prevent an obese or overweight condition from developing, or to maintain a healthy weight.

The compounds and compositions of the present invention are useful for the treatment or prevention of disorders associated with excessive food intake, such as obesity and obesity-related disorders. The obesity herein may be due to any cause, whether genetic or environmental.

The obesity-related disorders herein are associated with, caused by, or result from obesity. Examples of obesity-related disorders include overeating, binge eating, bulimia nervosa, hypertension, type 2 diabetes, elevated plasma insulin concentrations, hyperinsulinemia, insulin resistance, glucose intolerance, dyslipidemia, hyperlipidemia, endometrial cancer, breast cancer, prostate cancer, kidney cancer, colon cancer, osteoarthritis, obstructive sleep apnea, cholelithiasis, cholecystitis, gallstones, gout, gallbladder disease, abnormal heart rhythms and arrythmias, myocardial infarction, congestive heart failure, coronary heart disease, angina pectoris, sudden death, stroke, metabolic syndrome, psychological disorders (depression, eating disorders, distorted bodyweight, and low self esteem), and other pathological conditions showing reduced metabolic activity or a decrease in resting energy expenditure as a percentage of total fat-free mass, e.g, children with acute lymphoblastic leukemia. Further examples of obesity-related disorders are sexual and reproductive dysfunction, such as polycystic ovary disease, infertility, hypogonadism in males and hirsutism in females, gastrointestinal motility disorders, such as obesity-related gastro-esophageal reflux, respiratory disorders, such as obesity-hypoventilation syndrome (Pickwickian syndrome), cardiovascular disorders, inflammation, such as systemic inflammation of the vasculature, arteriosclerosis, hypercholesterolemia, hyperuricaemia, lower back pain, gallbladder disease, gout, and kidney cancer. Additionally, the present compounds are useful in the treatment of any condition in which it is desirable to lose weight or to reduce food intake. Additionally, the present compounds are useful in the treatment of any condition in which it is desirable to enhance cognition and memory, such as Alzheimer's Disease. The compositions of the present invention are also useful for reducing the risk of secondary outcomes of obesity, such as reducing the risk of left ventricular hypertrophy. Therefore, the present invention provides methods of treatment or prevention of such diseases, conditions and/or disorders modulated by CCK-1 receptor agonists in an animal which comprises administering to the animal in need of such treatment a compound of formula I, II, or III, in particular a therapeutically or prophylactically effective amount thereof.

Some agonists encompassed by formula I, II, and III show highly selective affinity for the cholecystokinin-1 receptor (CCK-1R) relative to cholecystokinin-2 receptor CCK-2R (also known as the CCK-B receptor), which makes them especially useful in the prevention and treatment of obesity, diabetes, and obesity related disorders. Compounds of the present invention are at least 500 fold more selective for the CCK-1 receptor than for the CCK-2 receptor.

The term “metabolic syndrome”, also known as syndrome X, is defined in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP-III). E. S. Ford et al., JAMA, vol. 287 (3), Jan. 16, 2002, pp 356-359. Briefly, a person is defined as having metabolic syndrome if the person has three or more of the following symptoms: abdominal obesity, hypertriglyceridemia, low HDL cholesterol, high blood pressure, and high fasting plasma glucose. The criteria for these are defined in ATP-III.

The term “diabetes,” as used herein, includes both insulin-dependent diabetes mellitus (i.e., IDDM, also known as type I diabetes) and non-insulin-dependent diabetes mellitus (i.e., NIDDM, also known as Type II diabetes). Type I diabetes, or insulin-dependent diabetes, is the result of an absolute deficiency of insulin, the hormone which regulates glucose utilization. Type II diabetes, or insulin-independent diabetes (i.e., non-insulin-dependent diabetes mellitus), often occurs in the face of normal, or even elevated levels of insulin and appears to be the result of the inability of tissues to respond appropriately to insulin. Most of the Type II diabetics are also obese. The compositions of the present invention are useful for treating both Type I and Type II diabetes. The compositions are especially effective for treating Type I diabetes. The compounds or combinations of the present invention are also useful for treating and/or preventing gestational diabetes mellitus.

Treatment of diabetes mellitus refers to the administration of a compound or combination of the present invention to treat diabetes. One outcome of treatment may be decreasing the glucose level in a subject with elevated glucose levels. Another outcome of treatment may be improving glycemic control. Another outcome of treatment may be decreasing insulin levels in a subject with elevated insulin levels. Another outcome of treatment may be decreasing plasma triglycerides in a subject with elevated plasma triglycerides. Another outcome of treatment may be lowering LDL cholesterol in a subject with high LDL cholesterol levels. Another outcome of treatment may be increasing HDL cholesterol in a subject with low HDL cholesterol levels. Another outcome may be decreasing the LDL/HDL ratio in a subject in need thereof. Another outcome of treatment may be increasing insulin sensivity. Another outcome of treatment may be enhancing glucose tolerance in a subject with glucose intolerance. Another outcome of treatment may be decreasing insulin resistance in a subject with increased insulin resistance or elevated levels of insulin. Another outcome may be decreasing triglycerides in a subject with elevated triglycerides. Yet another outcome may be improving LDL cholesterol, non-HDL cholesterol, triglyceride, HDL cholesterol or other lipid analyte profiles.

Prevention of diabetes mellitus refers to the administration of a compound or combination of the present invention to prevent the onset of diabetes in a subject at risk thereof.

“Obesity” is a condition in which there is an excess of body fat. The operational definition of obesity is based on the Body Mass Index (BMI), which is calculated as body weight per height in meters squared (kg/m²). “Obesity” refers to a condition whereby an otherwise healthy subject has a Body Mass Index (BMI) greater than or equal to 30 kg/m², or a condition whereby a subject with at least one co-morbidity has a BMI greater than or equal to 27 kg/m². An “obese subject” is an otherwise healthy subject with a Body Mass Index (BMI) greater than or equal to 30 kg/m² or a subject with at least one co-morbidity with a BMI greater than or equal to 27 kg/m². A “subject at risk of obesity” is an otherwise healthy subject with a BMI of 25 kg/m² to less than 30 kg/m² or a subject with at least one co-morbidity with a BMI of 25 kg/m² to less than 27 kg/m².

The increased risks associated with obesity occur at a lower Body Mass Index (BMI) in Asians. In Asian countries, including Japan, “obesity” refers to a condition whereby a subject with at least one obesity-induced or obesity-related co-morbidity, that requires weight reduction or that would be improved by weight reduction, has a BMI greater than or equal to 25 kg/m². In Asian countries, including Japan, an “obese subject” refers to a subject with at least one obesity-induced or obesity-related co-morbidity that requires weight reduction or that would be improved by weight reduction, with a BMI greater than or equal to 25 kg/m². In Asia-Pacific, a “subject at risk of obesity” is a subject with a BMI of greater than 23 kg/m² to less than 25 kg/m².

As used herein, the term “obesity” is meant to encompass all of the above definitions of obesity.

Obesity-induced or obesity-related co-morbidities include, but are not limited to, diabetes, non-insulin dependent diabetes mellitus-type II (2), impaired glucose tolerance, impaired fasting glucose, insulin resistance syndrome, dyslipidemia, hypertension, hyperuricacidemia, gout, coronary artery disease, myocardial infarction, angina pectoris, sleep apnea syndrome, Pickwickian syndrome, fatty liver; cerebral infarction, cerebral thrombosis, transient ischemic attack, orthopedic disorders, arthritis deformans, lumbodynia, emmeniopathy, and infertility. In particular, co-morbidities include: hypertension, hyperlipidemia, dyslipidemia, glucose intolerance, cardiovascular disease, sleep apnea, diabetes mellitus, and other obesity-related conditions.

Treatment of obesity and obesity-related disorders refers to the administration of the compounds or combinations of the present invention to reduce or maintain the body weight of an obese subject. One outcome of treatment may be reducing the body weight of an obese subject relative to that subject's body weight immediately before the administration of the compounds or combinations of the present invention. Another outcome of treatment may be preventing body weight regain of body weight previously lost as a result of diet, exercise, or pharmacotherapy. Another outcome of treatment may be decreasing the occurrence of and/or the severity of obesity-related diseases. The treatment may suitably result in a reduction in food or calorie intake by the subject, including a reduction in total food intake, or a reduction of intake of specific components of the diet such as carbohydrates or fats; and/or the inhibition of nutrient absorption; and/or the inhibition of the reduction of metabolic rate; and in weight reduction in subjects in need thereof. The treatment may also result in an alteration of metabolic rate, such as an increase in metabolic rate, rather than or in addition to an inhibition of the reduction of metabolic rate; and/or in minimization of the metabolic resistance that normally results from weight loss.

Prevention of obesity and obesity-related disorders refers to the administration of the compounds or combinations of the present invention to reduce or maintain the body weight of a subject at risk of obesity. One outcome of prevention may be reducing the body weight of a subject at risk of obesity relative to that subject's body weight immediately before the administration of the compounds or combinations of the present invention. Another outcome of prevention may be preventing body weight regain of body weight previously lost as a result of diet, exercise, or pharmacotherapy. Another outcome of prevention may be preventing obesity from occurring if the treatment is administered prior to the onset of obesity in a subject at risk of obesity. Another outcome of prevention may be decreasing the occurrence and/or severity of obesity-related disorders if the treatment is administered prior to the onset of obesity in a subject at risk of obesity. Moreover, if treatment is commenced in already obese subjects, such treatment may prevent the occurrence, progression or severity of obesity-related disorders, such as, but not limited to, arteriosclerosis, Type II diabetes, polycystic ovary disease, cardiovascular diseases, osteoarthritis, hypertension, dyslipidemia, insulin resistance, hypercholesterolemia, hypertriglyceridemia, and cholelithiasis.

The terms “administration of” and or “administering” a compound should be understood to mean providing a compound of the invention or a prodrug of a compound of the invention to a subject in need of treatment. The administration of the compounds of the present invention in order to practice the present methods of therapy is carried out by administering a therapeutically effective amount of the compound to a subject in need of such treatment or prophylaxis. The need for a prophylactic administration according to the methods of the present invention is determined via the use of well known risk factors.

The term “therapeutically effective amount” as used herein means the amount of the active compound that will elicit the biological or medical response in a tissue, system, subject, mammal, or human that is being sought by the researcher, veterinarian, medical doctor or other clinician, which includes alleviation of the symptoms of the disorder being treated. The novel methods of treatment of this invention are for disorders known to those skilled in the art. The term “prophylactically effective amount” as used herein means the amount of the active compound that will elicit the biological or medical response in a tissue, system, subject, mammal, or human that is being sought by the researcher, veterinarian, medical doctor or other clinician, to prevent the onset of the disorder in subjects as risk for obesity or the disorder. The therapeutically or prophylactically effective amount, or dosage, of an individual compound is determined, in the final analysis, by the physician in charge of the case, but depends on factors such as the exact disease to be treated, the severity of the disease and other diseases or conditions from which the patient suffers, the chosen route of administration, other drugs and treatments which the patient may concomitantly require, and other factors in the physician's judgement.

Administration and Dose Ranges

Any suitable route of administration may be employed for providing a subject or mammal, especially a human with an effective dosage of a compound of the present invention. For example, oral, rectal, topical, parenteral, ocular, pulmonary, nasal, and the like may be employed. Dosage forms include tablets, troches, dispersions, suspensions, solutions, capsules, creams, ointments, aerosols, and the like. Preferably the compound of Formula I, II, or III is administered orally or topically.

The effective dosage of active ingredient employed may vary depending on the particular compound employed, the mode of administration, the condition being treated and the severity of the condition being treated. Such dosage may be ascertained readily by a person skilled in the art.

When treating obesity, in conjunction with diabetes and/or hyperglycemia, or alone, generally satisfactory results are obtained when the compound of formula I, II, or III is administered at a daily dosage of from about 0.001 milligram to about 50 milligrams per kilogram of animal body weight, preferably given in a single dose or in divided doses two to six times a day, or in sustained release form. In the case of a 70 kg adult human, the total daily dose will generally be from about 0.07 milligrams to about 3500 milligrams. This dosage regimen may be adjusted to provide the optimal therapeutic response.

When treating diabetes mellitus and/or hyperglycemia, as well as other diseases or disorders for which the compound of formula I, I, or III is useful, generally satisfactory results are obtained when the compounds of the present invention are administered at a daily dosage of from about 0.001 milligram to about 50 milligram per kilogram of animal body weight, preferably given in a single dose or in divided doses two to six times a day, or in sustained release form. In the case of a 70 kg adult human, the total daily dose will generally be from about 0.07 milligrams to about 3500 milligrams. This dosage regimen may be adjusted to provide the optimal therapeutic response.

When treating dyslipidemia, bulimia nervosa, and gallstones satisfactory results are obtained when the compound of formula I, II, or III is administered at a daily dosage of from about 0.001 milligram to about 50 milligrams per kilogram of animal body weight, preferably given in a single dose or in divided doses two to six times a day, or in sustained release form. In the case of a 70 kg adult human, the total daily dose will generally be from about 0.07 milligrams to about 3500 milligrams. This dosage regimen may be adjusted to provide the optimal therapeutic response.

In the case where an oral composition is employed, a suitable dosage range is, e.g. from about 0.01 mg to about 1500 mg of a compound of Formula I, II, or III per day, preferably from about 0.1 mg to about 600 mg per day, more preferably from about 0.1 mg to about 100 mg per day. For oral administration, the compositions are preferably provided in the form of tablets containing from 0.01 to 1,000 mg, preferably 0.01, 0.05, 0.1, 0.5, 1, 2.5, 5, 10, 15, 20, 25, 30, 40, 50, 100, 250, 500, 600, 750, 1000, 1250 or 1500 milligrams of the active ingredient for the symptomatic adjustment of the dosage to the patient to be treated.

For use where a composition for intranasal administration is employed, intranasal formulations for intranasal administration comprising 0.001-10% by weight solutions or suspensions of the compound of formula I, II, or III in an acceptable intranasal formulation may be used.

For use where a composition for intravenous administration is employed, a suitable dosage range is from about 0.001 mg to about 50 mg, preferably from 0.01 mg to about 50 mg, more preferably 0.1 mg to 10 mg, of a compound of formula I, II, or III per kg of body weight per day. This dosage regimen may be adjusted to provide the optimal therapeutic response. It may be necessary to use dosages outside these limits in some cases.

For the treatment of diseases of the eye, ophthalmic preparations for ocular administration comprising 0.001-1% by weight solutions or suspensions of the compound of formula I, II, or III in an acceptable ophthalmic formulation may be used.

The magnitude of prophylactic or therapeutic dosage of the compounds of the present invention will, of course, vary depending on the particular compound employed, the mode of administration, the condition being treated and the severity of the condition being treated. It will also vary according to the age, weight and response of the individual patient. Such dosage may be ascertained readily by a person skilled in the art.

A compound of formula I, II, or III may be used in combination with other drugs that are used in the treatment/prevention/suppression or amelioration of the diseases or conditions for which compounds of formula I, II, or III are useful. Such other drugs may be administered, by a route and in an amount commonly used therefor, contemporaneously or sequentially with a compound of formula I, II, or III. When a compound of formula I, II, or III is used contemporaneously with one or more other drugs, a pharmaceutical composition containing such other drugs in addition to the compound of Formula I is preferred. Accordingly, the pharmaceutical compositions of the present invention include those that also contain one or more other active ingredients, in addition to a compound of formula I, I, or III. Examples of other active ingredients that may be combined with a compound of formula I, II, and III for the treatment or prevention of obesity and/or diabetes, either administered separately or in the same pharmaceutical compositions, include, but are not limited to:

(a) insulin sensitizers including (i) PPARγ antagonists such as glitazones (e.g. ciglitazone; darglitazone; englitazone; isaglitazone (MCC-555); pioglitazone; rosiglitazone; troglitazone; tularik; BRL49653; CLX-0921; 5-BTZD), GW-0207, LG-100641, and LY-300512, and the like), and compounds disclosed in WO 97/10813, WO 97/27857, WO 97/28115, WO 97/28137, and WO 97/27847; (iii) biguanides such as metformin and phenformin;

(b) insulin or insulin mimetics, such as biota, LP-100, novarapid, insulin detemir, insulin lispro, insulin glargine, insulin zinc suspension (lente and ultralente); Lys-Pro insulin, GLP-1 (73-7) (insulintropin); and GLP-1 (7-36)-NH₂);

(c) sulfonylureas, such as acetohexamide; chlorpropamide; diabinese; glibenclamide; glipizide; glyburide; glimepiride; gliclazide; glipentide; gliquidone; glisolamide; tolazamide; and tolbutamide;

(d) α-glucosidase inhibitors, such as acarbose, adiposine; camiglibose; emiglitate; miglitol; voglibose; pradimicin-Q; salbostatin; trestatin, tendamistate, CKD-711; MDL-25,637; MDL-73,945; and MOR 14, and the like;

(e) cholesterol lowering agents such as (i) HMG-CoA reductase inhibitors (atorvastatin, itavastatin, fluvastatin, lovastatin, pravastatin, rivastatin, rosuvastatin, simvastatin, and other statins), (ii) bile acid absorbers/sequestrants, such as cholestyramine, colestipol, dialkylaminoalkyl derivatives of a cross-linked dextran; Colestid®; LoCholest®, and the like, (ii) nicotinyl alcohol, nicotinic acid or a salt thereof, (iii) proliferator-activater receptor α agonists such as fenofibric acid derivatives (gemfibrozil, clofibrate, fenofibrate and benzafibrate), (iv) inhibitors of cholesterol absorption such as stanol esters, beta-sitosterol, sterol glycosides such as tiqueside; and azetidinones such as ezetimibe, and the like, and (acyl CoA:cholesterol acyltransferase (ACAT)) inhibitors such as avasimibe, and melinamide, (v) anti-oxidants, such as probucol, (vi) vitamin E, and (vii) thyromimetics;

(f) PPARα agonists such as beclofibrate, benzafibrate, ciprofibrate, clofibrate, etofibrate, fenofibrate, and gemfibrozil; and other fibric acid derivatives, such as Atromid®, Lopid® and Tricor®, and the like, and PPARα agonists as described in WO 97/36579 by Glaxo;

(g) PPARδ agonists, such as those disclosed in WO97/28149;

(h) PPAR α/δ agonists, such as muraglitazar, and the compounds disclosed in U.S. Pat. No. 6,414,002;

(i) smoking cessation agents, such as a nicotine agonist or a partial nicotine agonist such as varenicline, or a monoamine oxidase inhibitor (MAOI), or another active ingredient demonstrating efficacy in aiding cessation of tobacco consumption; for example, an antidepressant such as bupropion, doxepine, ornortriptyline; or an anxiolytic such as buspirone or clonidine; and

(j) anti-obesity agents, such as (1) growth hormone secretagogues, growth hormone secretagogue receptor agonists/antagonists, such as NN703, hexarelin, MK-0677, SM-130686, CP-424,391, L-692,429, and L-163,255, and such as those disclosed in U.S. Pat. Nos. 5,536,716, and 6,358,951, U.S. Patent Application Nos. 2002/049196 and 2002/022637, and PCT Application Nos. WO 01/56592 and WO 02/32888; (2) protein tyrosine phosphatase-1B (PTP-1B) inhibitors; (3) cannabinoid receptor ligands, such as cannabinoid CB₁ receptor antagonists or inverse agonists, such as rimonabant (Sanofi Synthelabo), AMT-251, and SR-14778 and SR 141716A (Sanofi Synthelabo), SLV-319 (Solvay), BAY 65-2520 (Bayer), and those disclosed in U.S. Pat. Nos. 5,532,237, 4,973,587, 5,013,837, 5,081,122, 5,112,820, 5,292,736, 5,624,941, 6,028,084, PCT Application Nos. WO 96/33159, WO 98/33765, WO98/43636, WO98/43635, WO 01/09120, WO98/31227, WO98/41519, WO98/37061, WO00/10967, WO/00/10968, WO97/29079, WO99/02499, WO 01/58869, WO 01/64632, WO 01/64633, WO 01/64634, WO02/076949, WO 03/007887, WO 04/048317, and WO 05/000809; and EPO Application No. EP-658546, EP-656354, EP-576357; (4) anti-obesity serotonergic agents, such as fenfluramine, dexfenfluramine, phentermine, and sibutramine; (5) β3-adrenoreceptor agonists, such as AD9677/TAK677 (Dainippon/Takeda), CL-316,243, SB 418790, BRL-37344, L-796568, BMS-196085, BRL-35135A, CGP12177A, BTA-243, Trecadrine, Zeneca D7114, SR 59119A, and such as those disclosed in U.S. Pat. No. 5,705,515, and U.S. Pat. No. 5,451,677 and PCT Patent Publications WO94/18161, WO95/29159, WO97/46556, WO98/04526 and WO98/32753, WO 01/74782, and WO 02/32897; (6) pancreatic lipase inhibitors, such as orlistat (Xenical®), Triton WR1339, RHC80267, lipstatin, tetrahydrolipstatin, teasaponin, diethylumbelliferyl phosphate, and those disclosed in PCT Application No. WO 01/77094; (7) neuropeptide Y1 antagonists, such as BIBP3226, J-115814, BIBO 3304, LY-357897, CP-671906, GI-264879A, and those disclosed in U.S. Pat. No. 6,001,836, and PCT Patent Publication Nos. WO 96/14307, WO 01/23387, WO 99/51600, WO 01/85690, WO 01/85098, WO 01/85173, and WO 01/89528; (8) neuropeptide Y5 antagonists, such as GW-569180A, GW-594884A, GW-587081X, GW-548118X, FR226928, FR240662, FR252384, 1229U91, GI-264879A, CGP71683A, LY-377897, PD-160170, SR-120562A, SR-120819A and JCF-104, and those disclosed in U.S. Pat. Nos. 6,057,335; 6,043,246; 6,140,354; 6,166,038; 6,180,653; 6,191,160; 6,313,298; 6,335,345; 6,337,332; 6,326,375; 6,329,395; 6,340,683; 6,388,077; 6,462,053; 6,649,624; and 6,723,847, hereby incorporated by reference in their entirety; European Patent Nos. EP-01010691, and EP-01044970; and PCT International Patent Publication Nos. WO 97/19682, WO 97/20820, WO 97/20821, WO 97/20822, WO 97/20823, WO 98/24768; WO 98/25907; WO 98/25908; WO 98/27063, WO 98/47505; WO 98/40356; WO 99/15516; WO 99/27965; WO 00/64880, WO 00/68197, WO 00/69849, WO 01/09120, WO 01/14376; WO 01/85714, WO 01/85730, WO 01/07409, WO 01/02379, WO 01/02379, WO 01/23388, WO 01/23389, WO 01/44201, WO 01/62737, WO 01/62738, WO 01/09120, WO 02/22592, WO 02/48152, and WO 02/49648; WO 02/094825; WO 03/014083; WO 03/10191; WO 03/092889; WO 04/002986; and WO 04/031175; (9) melanin-concentrating hormone (MCH) receptor antagonists, such as those disclosed in WO 01/21577 and WO 01/21169; (10) melanin-concentrating hormone 1 receptor (MCH1R) antagonists, such as T-226296 (Takeda), and those disclosed in PCT Patent Application Nos. WO 01/82925, WO 01/87834, WO 02/051809, WO 02/06245, WO 02/076929, WO 02/076947, WO 02/04433, WO 02/51809, WO 02/083134, WO 02/094799, WO 03/004027, and Japanese Patent Application Nos. JP 13226269, and JP 2004-139909; (11) melanin-concentrating hormone 2 receptor (MCH2R) agonist/antagonists; (12) orexin-1 receptor antagonists, such as SB-334867-A, and those disclosed in PCT Patent Application Nos. WO 01/96302, WO 01/68609, WO 02/51232, and WO 02/51838; (13) serotonin reuptake inhibitors such as fluoxetine, paroxetine, and sertraline, and those disclosed in U.S. Pat. No. 6,365,633, and PCT Patent Application Nos. WO 01/27060 and WO 01/162341; (14) melanocortin agonists, such as Melanotan II, CHIR86036 (Chiron), ME-10142, and ME-10145 (Melacure), CHIR86036 (Chiron); PT-141, and PT-14 (Palatin); (15) other MC4R (melanocortin 4 receptor) agonists, such as those disclosed in: U.S. Pat. Nos. 6,410,548; 6,294,534; 6,350,760; 6,458,790; 6,472,398; 6,376,509; and 6,818,658; US Patent Publication No. US2002/0137664; US2003/0236262; US2004/009751; US2004/0092501; and PCT Application Nos. WO 99/64002; WO 00/74679; WO 01/70708; WO 01/70337; WO 01/74844; WO 01/91752; WO 01/991752; WO 02/15909; WO 02/059095; WO 02/059107; WO 02/059108; WO 02/059117; WO 02/067869; WO 02/068387; WO 02/068388; WO 02/067869; WO 02/11715; WO 02/12166; WO 02/12178; WO 03/007949; WO 03/009847; WO 04/024720; WO 04/078716; WO 04/078717; WO 04/087159; WO 04/089307; and WO 05/009950; (16) 5HT-2 agonists; (17) 5HT2C (serotonin receptor 2C) agonists, such as BVT933, DPCA37215, WAY161503, R-1065, and those disclosed in U.S. Pat. No. 3,914,250, and PCT Application Nos. WO 02/36596, WO 02/48124, WO 02/10169, WO 01/66548, WO 02/44152, WO 02/51844, WO 02/40456, and WO 02/40457; (18) galanin antagonists; (19) CCK agonists; (20) other CCK-1 (cholecystokinin-A) agonists, such as AR-R 15849, GI 181771, JMV-180, A-71378, A-71623 and SR146131, and those described in U.S. Pat. No. 5,739,106; (21) GLP-1 agonists; (22) corticotropin-releasing hormone agonists; (23) histamine receptor-3 (H3) modulators; (24) histamine receptor-3 (H3) antagonists/inverse agonists, such as hioperamide, 3-(1H-imidazol-4-yl)propyl N-(4-pentenyl)carbamate, clobenpropit, iodophenpropit, imoproxifan, GT2394 (Gliatech), and those described and disclosed in PCT Application No. WO 02/15905, and O-[3-(1H-imidazol-4-yl)propanol]-carbamates (Kiec-Kononowicz, K. et al., Pharmazie, 55:349-55 (2000)), piperidine-containing histamine H3-receptor antagonists (Lazewska, D. et al., Pharmazie, 56:927-32 (2001), benzophenone derivatives and related compounds (Sasse, A. et al., Arch. Pharm. (Weinheim) 334:45-52 (2001)), substituted N-phenylcarbamates (Reidemeister, S. et al., Pharmazie, 55:83-6 (2000)), and proxifan derivatives (Sasse, A. et al., J. Med. Chem. 43:3335-43 (2000)); (25) β-hydroxy steroid dehydrogenase-1 inhibitors (β-HSD-1); 26) PDE (phosphodiesterase) inhibitors, such as theophylline, pentoxifylline, zaprinast, sildenafil, amrinone, milrinone, cilostamide, rolipram, and cilomilast; (27) phosphodiesterase-3B (PDE3B) inhibitors; (28) NE (norepinephrine) transport inhibitors, such as GW 320659, despiramine, talsupram, and nomifensine; (29) ghrelin receptor antagonists, such as those disclosed in PCT Application Nos. WO 01/87335, and WO 02/08250; (30) leptin, including recombinant human leptin (PEG-OB, Hoffman La Roche) and recombinant methionyl human leptin (Amgen); (31) leptin derivatives, such as those disclosed in U.S. Pat. Nos. 5,552,524, 5,552,523, 5,552,522, 5,521,283, and PCT International Publication Nos. WO 96/23513, WO 96/23514, WO 96/23515, WO 96/23516, WO 96/23517, WO 96/23518, WO 96/23519, and WO 96/23520; (32) BRS3 (bombesin receptor subtype 3) agonists such as [D-Phe6,beta-Ala11,Phe13,Nle14]Bn(6-14) and [D-Phe6,Phe13]Bn(6-13)propylamide, and those compounds disclosed in Pept. Sci. 2002 August; 8(8): 461-75); (33) CNTF (Ciliary neurotrophic factors), such as GI-181771 (Glaxo-SmithKline), SR146131 (Sanofi Synthelabo), butabindide, PD 170,292, and PD 149164 (Pfizer); (34) CNTF derivatives, such as axokine (Regeneron), and those disclosed in PCT Application Nos. WO 94/09134, WO 98/22128, and WO 99/43813; (35) monoamine reuptake inhibitors, such as sibutramine, and those disclosed in U.S. Pat. Nos. 4,746,680, 4,806,570, and 5,436,272, U.S. Patent Publication No. 2002/0006964 and PCT Application Nos. WO 01/27068, and WO 01/62341; (36) UCP-1 (uncoupling protein-1), 2, or 3 activators, such as phytanic acid, 4-[(E)-2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-napthalenyl)-1-propenyl]benzoic acid (TTNPB), retinoic acid, and those disclosed in PCT Patent Application No. WO 99/00123; (37) thyroid hormone β agonists, such as KB-2611 (KaroBioBMS), and those disclosed in PCT Application No. WO 02/15845, and Japanese Patent Application No. JP 2000256190; (38) FAS (fatty acid synthase) inhibitors, such as Cerulenin and C75; (39) DGAT1 (diacylglycerol acyltransferase 1) inhibitors; (40) DGAT2 (diacylglycerol acyltransferase 2) inhibitors; (41) ACC2 (acetyl-CoA carboxylase-2) inhibitors; (42) glucocorticoid antagonists; (43) acyl-estrogens, such as oleoyl-estrone, disclosed in del Mar-Grasa, M. et al., Obesity Research, 9:202-9 (2001); (44) dipeptidyl peptidase IV (DP-IV) inhibitors, such as isoleucine thiazolidide, valine pyrrolidide, NVP-DPP728, LAF237, P93/01, TSL 225, TMC-2A/2B/2C, FE 999011, P9310/K364, VIP 0177, SDZ 274-444 and sitagliptin; and the compounds disclosed in U.S. Pat. No. 6,699,871, which is incorporated herein by reference; and International Patent Application Nos. WO 03/004498; WO 03/004496; EP 1 258 476; WO 02/083128; WO 02/062764; WO 03/000250; WO 03/002530; WO 03/002531; WO 03/002553; WO 03/002593; WO 03/000180; and WO 03/000181; (46) dicarboxylate transporter inhibitors; (47) glucose transporter inhibitors; (48) phosphate transporter inhibitors; (49) Metformin (Glucophage®); and (50) Topiramate (Topimax®); and (50) peptide YY, PYY 3-36, peptide YY analogs, derivatives, and fragments such as BIM-43073D, BIM-43004C (Olitvak, D. A. et al., Dig. Dis. Sci. 44(3):643-48 (1999)), and those disclosed in U.S. Pat. No. 5,026,685, U.S. Pat. No. 5,604,203, U.S. Pat. No. 5,574,010, U.S. Pat. No. 5,696,093, U.S. Pat. No. 5,936,092, U.S. Pat. No. 6,046,162, U.S. Pat. No. 6,046,167, U.S. Pat. No. 6,093,692, U.S. Pat. No. 6,225,445, U.S. Pat. No. 5,604,203, U.S. Pat. No. 4,002,531, U.S. Pat. No. 4,179,337, U.S. Pat. No. 5,122,614, U.S. Pat. No. 5,349,052, U.S. Pat. No. 5,552,520, U.S. Pat. No. 6,127,355, WO 95/06058, WO 98/32466, WO 03/026591, WO 03/057235, WO 03/027637, and WO 2004/066966, which are incorporated herein by reference; (51) Neuropeptide Y2 (NPY2) receptor agonists such NPY3-36, N acetyl [Leu(28,31)] NPY 24-36, TASP-V, and cyclo-(28/32)-Ac-[Lys28-Glu32]-(25-36)-pNPY; (52) Neuropeptide Y4 (NPY4) agonists such as pancreatic peptide (PP) as described in Batterham et al., J. Clin. Endocrinol. Metab. 88:3989-3992 (2003), and other Y4 agonists such as 1229U91; (54) cyclo-oxygenase-2 inhibitors such as etoricoxib, celecoxib, valdecoxib, parecoxib, lumiracoxib, BMS347070, tiracoxib or JTE522, ABT963, CS502 and GW406381, and pharmaceutically acceptable salts thereof; (55) Neuropeptide Y1 (NPY1) antagonists such as BDBP3226, J-115814, BIBO 3304, LY-357897, CP-671906, GI-264879A and those disclosed in U.S. Pat. No. 6,001,836; and PCT Application Nos. WO 96/14307, WO 01/23387, WO 99/51600, WO 01/85690, WO 01/85098, WO 01/85173, and WO 01/89528; (56) Opioid antagonists such as nalmefene (Revex®), 3-methoxynaltrexone, naloxone, naltrexone, and those disclosed in: PCT Application No. WO 00/21509; (57) 11β HSD-1 (11-beta hydroxy steroid dehydrogenase type 1) inhibitors such as BVT 3498, BVT 2733, and those disclosed in WO 01/90091, WO 01/90090, WO 01/90092, and U.S. Pat. No. 6,730,690 and US Publication No. US 2004-0133011, which are incorporated by reference herein in their entirety; and (58) aminorex; (59) amphechloral; (60) amphetamine; (61) benzphetamine; (62) chlorphentermine; (63) clobenzorex; (64) cloforex; (65) clominorex; (66) clortermine; (67) cyclexedrine; (68) dextroamphetamine; (69) diphemethoxidine, (70) N-ethylamphetamine; (71) fenbutrazate; (72) fenisorex; (73) fenproporex; (74) fludorex; (75) fluminorex; (76) furfurylmethylamphetamine; (77) levamfetamine; (78) levophacetoperane; (79) mefenorex; (80) metamfepramone; (81) methamphetamine; (82) norpseudoephedrine; (83) pentorex; (84) phendimetrazine; (85) phenmetrazine; (86) picilorex; (87) phytopharm 57; (88) zonisamide, (89) neuromedin U and analogs or derivatives thereof, (90) oxyntomodulin and analogs or derivatives thereof; (91) Neurokinin-1 receptor antagonists (NK-1 antagonists) such as the compounds disclosed in: U.S. Pat. Nos. 5,162,339, 5,232,929, 5,242,930, 5,373,003, 5,387,595, 5,459,270, 5,494,926, 5,496,833, and 5,637,699; PCT International Patent Publication Nos. WO 90/05525, 90/05729, 91/09844, 91/18899, 92/01688, 92/06079, 92/12151, 92/15585, 92/17449, 92/20661, 92/20676, 92/21677, 92/22569, 93/00330, 93/00331, 93/01159, 93/01165, 93/01169, 93/01170, 93/06099, 93/09116, 93/10073, 93/14084, 93/14113, 93/118023, 93/19064, 93/21155, 93/21181, 93/23380, 93/24465, 94/00440, 94/01402, 94/02461, 94/02595, 94/03429, 94/03445, 94/04494, 94/04496, 94/05625, 94/07843, 94/08997, 94/10165, 94/10167, 94/10168, 94/10170, 94/11368, 94/13639, 94/13663, 94/14767, 94/15903, 94/19320, 94/19323, 94/20500, 94126735, 94/26740, 94/29309, 95/02595, 95/04040, 95/04042, 95/06645, 95/07886, 95/07908, 95/08549, 95/11880, 95/14017, 95/15311, 95/16679, 95/17382, 95/18124, 95/18129, 95/19344, 95/20575, 95/21819, 95/22525, 95/23798, 95/26338, 95/28418, 95/30674, 95/30687, 95/33744, 96/05181, 96/05193, 96/05203, 96/06094, 96/07649, 96/10562, 96/16939, 96/18643, 96/20197, 96/21661, 96/29304, 96/29317, 96/29326, 96/29328, 96/31214, 96/32385, 96/37489, 97/01553, 97/01554, 97/03066, 97/08144, 97/14671, 97/17362, 97/18206, 97/19084, 97/19942, 97/21702, and 97/49710; and 92) Qnexa.

Specific compounds of use in combination with a compound of the present invention include: simvastatin, mevastatin, ezetimibe, atorvastatin, sitagliptin, metformin, sibutramine, orlistat, Qnexa, topiramate, naltrexone, bupriopion, phentermine, and losartan, losartan with hydrochlorothiazide. Specific CB1 antagonists/inverse agonists of use in combination with a compound of the present invention include: those described in WO03/077847, including: N-[3-(4-chlorophenyl)-2(S)-phenyl-1(S)-methylpropyl]-2-(4-trifluoromethyl-2-pyrimidyloxy)-2-methylpropanamide, N-[3-(4-chlorophenyl)-2-(3-cyanophenyl)-1-methylpropyl]-2-(5-trifluoromethyl-2-pyridyloxy)-2-methylpropanamide, N-[3-(4-chlorophenyl)-2-(5-chloro-3-pyridyl)-1-methylpropyl]-2-(5-trifluoromethyl-2-pyridyloxy)-2-methylpropanamide, and pharmaceutically acceptable salts thereof; as well as those in WO05/000809, which includes the following: 3-{1-[bis(4-chlorophenyl)methyl]azetidin-3-ylidene}-3-(3,5-difluorophenyl)-2,2-dimethylpropanenitrile, 1-{1-[1-(4-chlorophenyl)pentyl]azetidin-3-yl}-1-(3,5-difluorophenyl)-2-methylpropan-2-ol. 3-((S)-(4-chlorophenyl) {3-[(1S)-1-(3,5-difluorophenyl)-2-hydroxy-2-methylpropyl]azetidin-1-yl}methyl)benzonitrile, 3-((S)-(4-chlorophenyl) {3-[(1S)-1-(3,5-difluorophenyl)-2-fluoro-2-methylpropyl]azetidin-1-yl}methyl)benzonitrile, 3-((4-chlorophenyl) {3-[1-(3,5-difluorophenyl)-2,2-dimethylpropyl]azetidin-1-yl}methyl)benzonitrile, 3-((1S)-1-{1-[(S)-(3-cyanophenyl)(4-cyanophenyl)methyl]azetidin-3-yl}-2-fluoro-2-methylpropyl)-5-fluorobenzonitrile, 3-[(S)-(4-chlorophenyl)(3-{(1S)-2-fluoro-1-[3-fluoro-5-(4H-1,2,4-triazol-4-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, and 5-((4-chlorophenyl) {3-[(1S)-1-(3,5-difluorophenyl)-2-fluoro-2-methylpropyl]azetidin-1-yl}methyl)thiophene-3-carbonitrile, and pharamecueitcally acceptable salts thereof; as well as: 3-[(S)-(4-chlorophenyl)(3-{(1S)-2-fluoro-1-[3-fluoro-5-(5-oxo-4,5-dihydro-1,3,4-oxadiazol-2-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 3-[(s)-(4-chlorophenyl)(3-{(1S)-2-fluoro-1-[3-fluoro-5-(1,3,4-oxadiazol-2-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 3-[(S)-(3-{(1S)-1-[3-(5-amino-1,3,4-oxadiazol-2-yl)-5-fluorophenyl]-2-fluoro-2-methylpropyl}azetidin-1-yl)(4-chlorophenyl)methyl]benzonitrile, 3-[(S)-(4-cyanophenyl)(3-{(1S)-2-fluoro-1-[3-fluoro-5-(5-oxo-4,5-dihydro-1,3,4-oxadiazol-2-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 3-[(s)-(3-{(1S)-1-[3-(5-amino-1,3,4-oxadiazol-2-yl)-5-fluorophenyl]-2-fluoro-2-methylpropyl}azetidin-1-yl)(4-cyanophenyl)methyl]benzonitrile, 3-[(S)-(4-cyanophenyl)(3-{(1S)-2-fluoro-1-[3-fluoro-5-(1,3,4-oxadiazol-2-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 3-[(S)-(4-chlorophenyl)(3-{(1S)-2-fluoro-1-[3-fluoro-5-(1,2,4-oxadiazol-3-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 3-[(1S)-1-(1-{(s)-(4-cyanophenyl)[3-(1,2,4-oxadiazol-3-yl)phenyl]-methyl}azetidin-3-yl)-2-fluoro-2-methylpropyl]-5-fluorobenzonitrile, 5-(3-{1-[1-(diphenylmethyl)azetidin-3-yl]-2-fluoro-2-methylpropyl}-5-fluorophenyl)-1H-tetrazole, 5-(3-{1-[1-(diphenylmethyl)azetidin-3-yl]-2-fluoro-2-methylpropyl}-5-fluorophenyl)-1-methyl-1H-tetrazole, 5-(3-{1-[1-(diphenylmethyl)azetidin-3-yl]-2-fluoro-2-methylpropyl}-5-fluorophenyl)-2-methyl-2H-tetrazole, 3-[(4-chlorophenyl)(3-{2-fluoro-1-[3-fluoro-5-(2-methyl-2H-tetrazol-5-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 3-[(4-chlorophenyl)(3-{2-fluoro-1-[3-fluoro-5-(1-methyl-1H-tetrazol-5-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 3-[(4-cyanophenyl)(3-{2-fluoro-1-[3-fluoro-5-(1-methyl-1H-tetrazol-5-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 3-[(4-cyanophenyl)(3-{2-fluoro-1-[3-fluoro-5-(2-methyl-2H-tetrazol-5-yl)phenyl]-2-methylpropyl}azetidin-1-yl)methyl]benzonitrile, 5-{3-[(S)-{3-[(1S)-1-(3-bromo-5-fluorophenyl)-2-fluoro-2-methylpropyl]azetidin-1-yl}(4-chlorophenyl)methyl]phenyl}-1,3,4-oxadiazol-2(3H)-one, 3-[(1S)-1-(1-{(S)-(4-chlorophenyl)[3-(5-oxo-4,5-dihydro-1,3,4-oxadiazol-2-yl)phenyl]methyl}azetidin-3-yl)-2-fluoro-2-methylpropyl]-5-fluorobenzonitrile, 3-[(1S)-1-(1-{(S)-(4-cyanophenyl)[3-(5-oxo-4,5-dihydro-1,3,4-oxadiazol-2-yl)phenyl]methyl}azetidin-3-yl)-2-fluoro-2-methylpropyl]-5-fluorobenzonitrile, 3-[(1S)-1-(1-{(S)-(4-cyanophenyl)[3-(1,3,4-oxadiazol-2-yl)phenyl]methyl}azetidin-3-yl)-2-fluoro-2-methylpropyl]-5-fluorobenzonitrile, 3-[(S)-1-(1-{(S)-(4-chlorophenyl)[3-(1,3,4-oxadiazol-2-yl)phenyl]methyl}azetidin-3-yl)-2-fluoro-2-methylpropyl]-5-fluorobenzonitrile, 3-((1S)-1-{1-[(s)-[3-(5-amino-1,3,4-oxadiazol-2-yl)phenyl](4-chlorophenyl)methyl]azetidin-3-yl}-2-fluoro-2-methylpropyl)-5-fluorobenzonitrile, 3-((1S)-1-{1-[(S)-[3-(5-amino-1,3,4-oxadiazol-2-yl)phenyl](4-cyanophenyl)methyl]azetidin-3-yl}-2-fluoro-2-methylpropyl)-5-fluorobenzonitrile, 3-[(1S)-1-(1-{(S)-(4-cyanophenyl)[3-(1,2,4-oxadiazol-3-yl)phenyl]methyl}azetidin-3-yl)-2-fluoro-2-methylpropyl]-5-fluorobenzonitrile, 3-[(1S)-1-(1-{(S)-(4-chlorophenyl)[3-(1,2,4-oxadiazol-3-yl)phenyl]methyl}azetidin-3-yl)-2-fluoro-2-methylpropyl]-5-fluorobenzonitrile, 5-[3-((S)-(4-chlorophenyl) {3-[(S)-1-(3,5-difluorophenyl)-2-fluoro-2-methylpropyl]azetidin-1-yl}methyl)phenyl]-1,3,4-oxadiazol-2(3H)-one, 5-[3-((S)-(4-chlorophenyl) {3-[(1S)-1-(3,5-difluorophenyl)-2-fluoro-2-methylpropyl]azetidin 1-yl}methyl)phenyl]-1,3,4-oxadiazol-2(3H)-one, 4-{(S)-{3-[(1S)-1-(3,5-difluorophenyl)-2-fluoro-2-methylpropyl]azetidin-1-yl}[3-(5-oxo-4,5-dihydro-1,3,4-oxadiazol-2-yl)phenyl]methyl}-benzonitrile, and pharmaceutically acceptable salts thereof.

Specific NPY5 antagonists of use in combination with a compound of the present invention include: 3-oxo-N-(5-phenyl-2-pyrazinyl)-spiro[isobenzofuran-1(3H), 4′-piperidine]-1′-carboxamide, 3-oxo-N-(7-trifluoromethylpyrido[3,2-b]pyridin-2-yl)spiro-[isobenzofuran-1(3H), 4′-piperidine]-1′-carboxamide, N-[5-(3-fluorophenyl)-2-pyrimidinyl]-3-oxospiro-[isobenzofuran-1(3H), 4′-piperidine]-1′-carboxamide, trans-3′-oxo-N-(5-phenyl-2-pyrimidinyl)spiro[cyclohexane-1,1′(3′H)-isobenzofuran]-4-carboxamide, trans-3′-oxo-N-[1-(3-quinolyl)-4-imidazolyl]spiro[cyclohexane-1,1′(3′H)-isobenzofuran]-4-carboxamide, trans-3-oxo-N-(5-phenyl-2-pyrazinyl)spiro[4-azaiso-benzofuran-1(3H), 1′-cyclohexane]-4′-carboxamide, trans-N-[5-(3-fluorophenyl)-2-pyrimidinyl]-3-oxospiro[5-azaisobenzofuran-1(3H), 1′-cyclohexane]-4′-carboxamide, trans-N-[5-(2-fluorophenyl)-2-pyrimidinyl]-3-oxospiro[5-azaisobenzofuran-1(3H), 1′-cyclohexane]-4′-carboxamide, trans-N-[1-(3,5-difluorophenyl)-4-imidazolyl]-3-oxospiro[7-azaisobenzofuran-1(3H), 1′-cyclohexane]-4′-carboxamide, trans-3-oxo-N-(1-phenyl-4-pyrazolyl)spiro[4-azaisobenzofuran-1(3H), 1′-cyclohexane]-4′-carboxamide, trans-N-[1-(2-fluorophenyl)-3-pyrazolyl]-3-oxospiro[6-azaisobenzofuran-1(3H), 1′-cyclohexane]-4′-carboxamide, trans-3-oxo-N-(1-phenyl-3-pyrazolyl)spiro[6-azaisobenzofuran-1(3H), 1′-cyclohexane]-4′-carboxamide, trans-3-oxo-N-(2-phenyl-1,2,3-triazol-4-yl)spiro[6-azaisobenzofuran-1(3H), 1′-cyclohexane]-4′-carboxamide, and pharmaceutically acceptable salts and esters thereof.

Specific ACC-1/2 inhibitors of use in combination with a compound of the present invention include: 1′-[(4,8-dimethoxyquinolin-2-yl)carbonyl]-6-(1H-tetrazol-5-yl)spiro[chroman-2,4′-piperidin]-4-one; (5-{1′-[(4,8-dimethoxyquinolin-2-yl)carbonyl]-4-oxospiro[chroman-2,4′-piperidin]-6-yl}-2H-tetrazol-2-yl)methyl pivalate; 5-{1′-[(8-cyclopropyl-4-methoxyquinolin-2-yl)carbonyl]-4-oxospiro[chroman-2,4′-piperidin]-6-yl}nicotinic acid; 1′-(8-methoxy-4-morpholin-4-yl-2-naphthoyl)-6-(1H-tetrazol-5-yl)spiro[chroman-2,4′-piperidin]-4-one; and 1′-[(4-ethoxy-8-ethylquinolin-2-yl)carbonyl]-6-(1H-tetrazol-5-yl)spiro[chroman-2,4′-piperidin]-4-one; and pharmaceutically acceptable salts and esters thereof. Specific MCH1R antagonist compounds of use in combination with a compound of the present invention include: 1-{4-[(1-ethylazetidin-3-yl)oxy]phenyl}-4-[(4-fluorobenzyl)oxy]pyridin-2(1H)-one, 4-[(4-fluorobenzyl)oxy]-1-{4-[(1-isopropylazetidin-3-yl)oxy]phenyl}pyridin-2(1H)-one, 1-[4-(azetidin-3-yloxy)phenyl]-4-[(5-chloropyridin-2-yl)methoxy]pyridin-2(1H)-one, 4-[(5-chloropyridin-2-yl)methoxy]-1-{4-[(1-ethylazetidin-3-yl)oxy]phenyl}pyridin-2(1H)-one, 4-[(5-chloropyridin-2-yl)methoxy]-1-{4-[(1-propylazetidin-3-yl)oxy]phenyl}pyridin-2(1H)-one, and 4-[(5-chloropyridin-2-yl)methoxy]-1-(4-{[(2S)-1-ethylazetidin-2-yl]methoxy}phenyl)pyridin-2(1H)-one, or a pharmaceutically acceptable salt thereof.

Specific DP-IV inhibitors of use in combination with a compound of the present invention are selected from 7-[(3R)-3-amino-4-(2,4,5-trifluorophenyl)butanoyl]-3-(trifluoromethyl)-5,6,7,8-tetrahydro-1,2,4-triazolo[4,3-a]pyrazine. In particular, the compound of formula I is favorably combined with 7-[(3R)-3-amino-4-(2,4,5-trifluorophenyl)butanoyl]-3-(trifluoromethyl)-5,6,7,8-tetrahydro-1,2,4-triazolo[4,3-a]pyrazine, and pharmaceutically acceptable salts thereof.

Specific H3 (histamine H3) antagonists/inverse agonists of use in combination with a compound of the present invention include: those described in WO05/077905, including: 3-{4-[(1-cyclobutyl-4-piperidinyl)oxy]phenyl}-2-ethylpyrido[2,3-d]-pyrimidin-4(3H)-one, 3-{4-[(1-cyclobutyl-4-piperidinyl)oxy]phenyl}-2-methylpyrido[4,3-d]pyrimidin-4(3H)-one, 2-ethyl-3-(4-{3-[(3S)-3-methylpiperidin-1-yl]propoxy}phenyl)pyrido[2,3-d]pyrimidin-4(3H)-one 2-methyl-3-(4-{3-[(3S)-3-methylpiperidin-1-yl]propoxy}phenyl)pyrido[4,3-d]pyrimidin-4(3H)-one, 3-{4-[(1-cyclobutyl-4-piperidinyl)oxy]phenyl}-2,5-dimethyl-4(3H)-quinazolinone, 3-{4-[(1-cyclobutyl-4-piperidinyl)oxy]phenyl}-2-methyl-5-trifluoromethyl-4(3H)-quinazolinone, 3-{4[(1-cyclobutyl-4-piperidinyl)oxy]phenyl}-5-methoxy-2-methyl-4(3H)-quinazolinone, 3-{4-[(1-cyclobutylpiperidin-4-yl)oxy]phenyl}-5-fluoro-2-methyl-4(3H)-quinazolinone, 3-{4-[(1-cyclobutylpiperidin-4-yl)oxy]phenyl}-7-fluoro-2-methyl-4(3H)-quinazolinone, 3-{4-[(1-cyclobutylpiperidin-4-yl)oxy]phenyl}-6-methoxy-2-methyl-4(3H)-quinazolinone, 3-{4-[(1-cyclobutylpiperidin-4-yl)oxy]phenyl}-6-fluoro-2-methyl-4(3H)-quinazolinone, 3-{4-[(1-cyclobutylpiperidin-4-yl)oxy]phenyl}-8-fluoro-2-methyl-4(3H)-quinazolinone, 3-{4-[(1-cyclopentyl-4-piperidinyl)oxy]phenyl}-2-methylpyrido[4,3-d]pyrimidin-4(3H)-one, 3-{4-[(1-cyclobutylpiperidin-4-yl)oxy]phenyl}-6-fluoro-2-methylpyrido[3,4-d]pyrimidin-4(3H)-one, 3-{4-[(1-cyclobutyl-4-piperidinyl)oxy]phenyl}-2-ethylpyrido[4,3-d]pyrimidin-4(3H)-one, 6-methoxy-2-methyl-3-{4-[3-(1-piperidinyl)propoxy]phenyl}pyrido[3,4-d]pyrimidin-4(3H)-one, 6-methoxy-2-methyl-3-{4-[3-(1-pyrrolidinyl)propoxy]phenyl}pyrido[3,4-d]pyrimidin-4(3H)-one, 2,5-dimethyl-3-{4-[3-(1-pyrrolidinyl)propoxy]phenyl}-4(3H)-quinazolinone, 2-methyl-3-(4-[3-(1-pyrrolidinyl)propoxy]phenyl}-5-trifluoromethyl-4(3H)-quinazolinone, 5-fluoro-2-methyl-3-{4-[3-(1-piperidinyl)propoxy]phenyl}-4(3H)-quinazolinone, 6-methoxy-2-methyl-3-{4-[3-(1-piperidinyl)propoxy]phenyl}-4(3H)-quinazolinone, 5-methoxy-2-methyl-3-(4-{3-[(3S)-3-methylpiperidin-1-yl]propoxy}phenyl)-4(3H)-quinazolinone, 7-methoxy-2-methyl-3-(4-{3-[(3S)-3-methylpiperidin-1-yl]propoxy}phenyl)-4(3H)-quinazolinone, 2-methyl-3-(4-{3-[(3S)-3-methylpiperidin-1-yl]propoxy}phenyl)pyrido[2,3-d]pyrimidin-4(3H)-one, 5-fluoro-2-methyl-3-(4-{3-[(2R)-2-methylpyrrolidin-1-yl]propoxy}phenyl)-4(3H)-quinazolinone, 2-methyl-3-(4-{3-[(2R)-2-methylpyrrolidin-1-yl]propoxy}phenyl)pyrido[4,3-d]pyrimidin-4(3H)-one, 6-methoxy-2-methyl-3-(4-{3-[(2R)-2-methylpyrrolidin-1-yl]propoxy}phenyl)-4(3H)-quinazolinone, 6-methoxy-2-methyl-3-(4-{3-[(2S)-2-methylpyrrolidin-1-yl]propoxy}phenyl)-4(3H)-quinazolinone, and pharmaceutically acceptable salts thereof.

Specific CCK1R agonists of use in combination with a compound of the present invention include: 3-(4-{[1-(3-ethoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-1-piperazinyl)-1-naphthoic acid; 3-(4-{[1-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-1-piperazinyl)-1-naphthoic acid; 3-(4-{[1-(3-ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl}-1-piperazinyl)-1-naphthoic acid; 3-(4-{[1-(3-ethoxyphenyl)-2-(2,4-difluorophenyl)-1H-imidazol-4-yl]carbonyl}-1-piperazinyl)-1-naphthoic acid; and 3-(4-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl}-1-piperazinyl)-1-naphthoic acid; and pharmaceutically acceptable salts thereof. Specific MC4R agonists of use in combination with a compound of the present invention include: 1) (5S)-1′-{[(3R,4R)-1-tert-butyl-3-(2,3,4-trifluorophenyl)piperidin-4-yl]carbonyl}-3-chloro-2-methyl-5-[1-methyl-1-(1-methyl-1H-1,2,4-triazol-5-yl)ethyl]-5H-spiro[furo[3,4-b]pyridine-7,4′-piperidine]; 2) (5R)-1′-{[(3R,4R)-1-tert-butyl-3-(2,3,4-trifluorophenyl)-piperidin-4-yl]carbonyl}-3-chloro-2-methyl-5-[1-methyl-1-(1-methyl-1H-1,2,4-triazol-5-yl)ethyl]-5H-spiro[spiro[3,4-b]pyridine-7,4′-piperidine]; 3) 2-(1′-{[(3S,4R)-1-tert-butyl-4-(2,4-difluorophenyl)pyrrolidin-3-yl]carbonyl}-3-chloro-2-methyl-5H-spiro[furo[3,4-b]pyridine-7,41-piperidin]-5-yl)-2-methylpropanenitrile; 4) 1′-{[(3S,4R)-1-tert-butyl-4-(2,4-difluorophenyl)pyrrolidin-3-yl]carbonyl}-3-chloro-2-methyl-5-[1-methyl-1-(1-methyl-1H-1,2,4-triazol-5-yl)ethyl]-5H-spiro[furo[3,4-b]pyridine-7,4′-piperidine]; 5) N-[(3R,4R)-3-({3-chloro-2-methyl-5-[1-methyl-1-(1-methyl-1H-1,2,4-triazol-5-yl)ethyl]-1′H,5H-spiro[furo-[3,4-b]pyridine-7,4′-piperidin]-1′-yl}carbonyl)-4-(2,4-difluorophenyl)-cyclopentyl]-N-methyltetrahydro-2H-pyran-4-amine; 6) 2-[3-chloro-1′-({(1R,2R)-2-(2,4-difluorophenyl)-4-[methyl(tetrahydro-2H-pyran-4-yl)amino]-cyclopentyl}-carbonyl)-2-methyl-5H-spiro[furo[3,4-b]pyridine-7,4′-piperidin]-5-yl]-2-methyl-propane-nitrile; and pharmaceutically acceptable salts thereof. Still further, neurokinin-1 (NK-1) receptor antagonists may be favorably employed in combination with a compound of the present invention. NK-1 receptor antagonists of use in the present invention are fully described in the art. Specific neurokinin-1 receptor antagonists of use in the present invention include: (±)-(2R3R,2S3S)—N-{[2-cyclopropoxy-5-(trifluoromethoxy)-phenyl]methyl}-2-phenylpiperidin-3-amine; 2-(R)-(1-(R)-(3,5-bis(trifluoromethyl)phenyl)ethoxy)-3-(S)-(4-fluorophenyl)-4-(3-(5-oxo-1H,4H-1,2,4-triazolo)methyl)morpholine; aperpitant; CJ17493; GW597599; GW679769; R673; R067319; R1124; R1204; SSR146977; SSR40600; T-2328; and T2763; or a pharmaceutically acceptable salts thereof.

Examples of other anti-obesity agents that can be employed in combination with a compound of formula I, II, or III are disclosed in “Patent focus on new anti-obesity agents,” Exp. Opin. Ther. Patents, 10: 819-831 (2000); “Novel anti-obesity drugs,” Exp. Opin. Invest. Drugs, 9: 1317-1326 (2000); and “Recent advances in feeding suppressing agents: potential therapeutic strategy for the treatment of obesity, Exp. Opin. Ther. Patents, 1: 1677-1692 (2001). The role of neuropeptide Y in obesity is discussed in Exp. Opin. Invest. Drugs, 9: 1327-1346 (2000). Cannabinoid receptor ligands are discussed in Exp. Opin. Invest. Drugs, 9: 1553-1571 (2000).

The instant invention also includes administration of a single pharmaceutical dosage formulation which contains the CCK-1R ligand or agonist in combination with a second active ingredient, as well as administration of each active agent in its own separate pharmaceutical dosage formulation. Where separate dosage formulations are used, the individual components of the composition can be administered at essentially the same time, i.e., concurrently, or at separately staggered times, i.e. sequentially prior to or subsequent to the administration of the other component of the composition. The instant invention is therefore to be understood to include all such regimes of simultaneous or alternating treatment, and the terms “administration” and “administering” are to be interpreted accordingly. Administration in these various ways are suitable for the present compositions as long as the beneficial pharmaceutical effect of the combination of the CCK-1R ligand or agonist and the second active ingredient is realized by the patient at substantially the same time. Such beneficial effect is preferably achieved when the target blood level concentrations of each active ingredient are maintained at substantially the same time. It is preferred that the combination of the CCK-1R ligand or agonist and the second active ingredient be co-administered concurrently on a once-a-day dosing schedule; however, varying dosing schedules, such as the CCK-1R ligand or agonist once a day and the second active ingredient once, twice or more times per day or the CCK-1R ligand or agonist three times a day and the second active ingredient once, twice or more times per day, is also encompassed herein. A single oral dosage formulation comprised of both a CCK-1R ligand or agonist and a second active ingredient is preferred. A single dosage formulation will provide convenience for the patient, which is an important consideration especially for patients with diabetes or obese patients who may be in need of multiple medications.

The compounds in the combinations of the present invention may be administered separately, therefore the invention also relates to combining separate pharmaceutical compositions into a kit form. The kit, according to this invention, comprises two separate pharmaceutical compositions: a first unit dosage form comprising a prophylactically or therapeutically effective amount of the cholecystokinin-1 receptor agonist, or a pharmaceutically acceptable salt or ester thereof, and a pharmaceutically acceptable carrier or diluent in a first unit dosage form, and a second unit dosage form comprising a prophylactically or therapeutically effective amount of the second active ingredient or drug, or a pharmaceutically acceptable salt or ester thereof, and a pharmaceutically acceptable carrier or diluent in a second unit dosage form. In one embodiment, the kit further comprises a container. Such kits are especially suited for the delivery of solid oral forms such as tablets or capsules. Such a kit preferably includes a number of unit dosages. Such kits can include a card having the dosages oriented in the order of their intended use. An example of such a kit is a “blister pack”. Blister packs are well known in the packaging industry and are widely used for packaging pharmaceutical unit dosage forms. If desired, a memory aid can be provided, for example in the form of numbers, letters, or other markings or with a calendar insert, designating the days or time in the treatment schedule in which the dosages can be administered.

Another aspect of the present invention provides pharmaceutical compositions which comprise a compound of formula I, II, or III, as an active ingredient or a pharmaceutically acceptable salt thereof, and may also contain a pharmaceutically acceptable carrier and optionally other therapeutic ingredients. The term “pharmaceutically acceptable salts” refers to salts prepared from pharmaceutically acceptable non-toxic bases or acids including inorganic bases or acids and organic bases or acids.

The compositions include compositions suitable for oral, rectal, topical, parenteral (including subcutaneous, intramuscular, and intravenous), ocular (ophthalmic), pulmonary (nasal or buccal inhalation), or nasal administration, although the most suitable route in any given case will depend on the nature and severity of the conditions being treated and on the nature of the active ingredient. They may be conveniently presented in unit dosage form and prepared by any of the methods well-known in the art of pharmacy.

In practical use, the compounds of formula I, II, and III can be combined as the active ingredient in intimate admixture with a pharmaceutical carrier according to conventional pharmaceutical compounding techniques. The carrier may take a wide variety of forms depending on the form of preparation desired for administration, e.g., oral or parenteral (including intravenous). In preparing the compositions for oral dosage form, any of the usual pharmaceutical media may be employed, such as, for example, water, glycols, oils, alcohols, flavoring agents, preservatives, coloring agents and the like in the case of oral liquid preparations, such as, for example, suspensions, elixirs and solutions; or carriers such as starches, sugars, microcrystalline cellulose, diluents, granulating agents, lubricants, binders, disintegrating agents and the like in the case of oral solid preparations such as, for example, powders, hard and soft capsules and tablets, with the solid oral preparations being preferred over the liquid preparations.

Because of their ease of administration, tablets and capsules represent the typical oral dosage unit form, in which case solid pharmaceutical carriers are typically employed. If desired, tablets may be coated by standard aqueous or nonaqueous techniques. Such compositions and preparations should contain at least 0.1 percent of active compound. The percentage of active compound in these compositions may, of course, be varied and may conveniently be between about 2 percent to about 60 percent of the weight of the unit. The amount of active compound in such therapeutically useful compositions is such that an effective dosage will be obtained. The active compounds can also be administered intranasally as, for example, liquid drops or spray.

The tablets, pills, capsules, and the like may also contain a binder such as gum tragacanth, acacia, corn starch or gelatin; excipients such as dicalcium phosphate; a disintegrating agent such as corn starch, potato starch, alginic acid; a lubricant such as magnesium stearate; and a sweetening agent such as sucrose, lactose or saccharin. When a dosage unit form is a capsule, it may contain, in addition to materials of the above type, a liquid carrier such as a fatty oil. Various other materials may be present as coatings or to modify the physical form of the dosage unit. For instance, tablets may be coated with shellac, sugar or both. A syrup or elixir may contain, in addition to the active ingredient, sucrose as a sweetening agent, methyl and propylparabens as preservatives, a dye and a flavoring such as cherry or orange flavor.

Compounds of formula I, II, or III may also be administered parenterally. Solutions or suspensions of these active compounds can be prepared in water suitably mixed with a surfactant such as hydroxy-propylcellulose. Dispersions can also be prepared in glycerol, liquid polyethylene glycols and mixtures thereof in oils. Under ordinary conditions of storage and use, these preparations contain a preservative to prevent the growth of microorganisms.

The pharmaceutical forms suitable for injectable use include sterile aqueous solutions or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions. In all cases, the form must be sterile and must be fluid to the extent that easy syringability exists. It must be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms such as bacteria and fungi. The carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (e.g. glycerol, propylene glycol and liquid polyethylene glycol), suitable mixtures thereof, and vegetable oils.

The compounds of formula I, II, and III of the present invention can be prepared according to the procedures of the following Schemes and Examples, using appropriate materials and are further exemplified by the following specific examples. Moreover, by utilizing the procedures described herein, one of ordinary skill in the art can readily prepare additional compounds of the present invention claimed herein. The compounds illustrated in the examples are not, however, to be construed as forming the only genus that is considered as the invention. The Examples further illustrate details for the preparation of the compounds of the present invention. Those skilled in the art will readily understand that known variations of the conditions and processes of the following preparative procedures can be used to prepare these compounds. The instant compounds are generally isolated in the form of their pharmaceutically acceptable salts, such as those described previously hereinabove. The free amine bases corresponding to the isolated salts can be generated by neutralization with a suitable base, such as aqueous sodium hydrogencarbonate, sodium carbonate, sodium hydroxide, and potassium hydroxide, and extraction of the liberated amine free base into an organic solvent followed by evaporation. The amine free base isolated in this manner can be further converted into another pharmaceutically acceptable salt by dissolution in an organic solvent followed by addition of the appropriate acid and subsequent evaporation, precipitation, or crystallization. All temperatures are degrees Celsius unless otherwise noted. Mass spectra (MS) were measured by electron-spray ion-mass spectroscopy.

The phrase “standard peptide coupling reaction conditions” means coupling a carboxylic acid with an amine using an acid activating agent such as EDC, DCC, and BOP in an inert solvent such as dichloromethane in the presence of a catalyst such as HOBT. The use of protecting groups for the amine and carboxylic acid functionalities to facilitate the desired reaction and minimize undesired reactions is well documented. Conditions required to remove protecting groups are found in standard textbooks such as Greene, T, and Wuts, P. G. M., Protective Groups in Organic Synthesis, John Wiley & Sons, Inc., New York, N.Y., 1991. CBZ and BOC are commonly used protecting groups in organic synthesis, and their removal conditions are known to those skilled in the art. For example, CBZ may be removed by catalytic hydrogenation in the presence of a noble metal or its oxide such as palladium on activated carbon in a protic solvent such as methanol or ethanol. In cases where catalytic hydrogenation is contraindicated due to the presence of other potentially reactive functionalities, removal of CBZ groups can also be achieved by treatment with a solution of hydrogen bromide in acetic acid or by treatment with a mixture of TFA and dimethylsulfide. Removal of BOC protecting groups is carried out with a strong acid, such as trifluoroacetic acid, hydrochloric acid, or hydrogen chloride gas, in a solvent such as methylene chloride, methanol, or ethyl acetate.

Abbreviations Used in the Description of the Preparation of the Compounds of the Present Invention: BOC (Boc) is t-butyloxycarbonyl, BOP is benzotriazol-1-yloxytris(dimethylamino)-phosphonium hexafluorophosphate, Bn is benzyl, Bu is butyl, calc. or calc'd is Calculated, celite is Celite™ diatomaceous earth, CBZ (Cbz) is benzyloxycarbonyl, c-hex is cyclohexyl, c-pen is cyclopentyl, c-pro is cyclopropyl, DCC is dicyclohexylcarbodiimide, DEAD is diethyl azodicarboxylate, DIEA is diisopropyl-ethylamine, DMAP is 4-dimethylaminopyridine, DMF is N,N-dimethylformamide, dppf is 1,1′-bis(diphenylphosphino)ferrocene, EDC is 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide, eq is equivalent(s), ES-MS and ESI-MS are electron spray ion-mass spectroscopy, Et is ethyl, EtOAc is ethyl acetate, g is gram(s), h or hr is hour(s), HATU is O-(7-azabenzotriazol-1-yl)-N,N,N′,N′-tetramethyluronium hexafluorophosphate, HMPA is hexamethyl phosphoramide, HOAc is acetic acid, HOAT is 1-hydroxy-7-azabenzotriazole, HOBt or HOBT is 1-hydroxybenzotriazole, HPLC is high performance liquid chromatography, LC/MS or LC-MASS is liquid chromatography mass spectrum, LDA is lithium diisopropylamide, CCK-xR is cholecystokinin receptor (x being a number), L is liter, Me is methyl, MeOH is methanol, MF is molecular formula, min is minutes, mg is milligram(s), mL is milliliter, mmol is millimole(s), MPLC is medium pressure liquid chromatography, MS is mass spectrum, Ms is methane sulfonyl, MTBE is tert-butyl methyl ether, NaHMDS is sodium hexamethyl disilazide, NaOtBu is sodium tert-butoxide, NMM is N-Methylmorpholine, NMO is N-Methylmorpholine-N-oxide, OTf is trifluoromethanesulfonyl, Pd₂(dba)₃ is tris(dibenzylideneacetone) dipalladium (0), Ph is phenyl, Phe is phenyl alanine, Pr is propyl, iPr is isopropyl, prep. is prepared, PyBOP is benzotriazol-1-yloxytripyrrolidine-phosphonium hexafluorophosphate, PyBrop is bromo-tris-pyrrolidino-phosphonium hexafluoro-phosphate, r.t. or rt is room temperature, SCF CO₂S is super critical fluid carbon dioxide, TEA or Et₃N is triethylamine, Tf is triflate or trifluoromethanesulfonate, TFA is trifluoroacetic acid, THF is tetrahydrofuran, and TLC is thin-layer chromatography.

Reaction Schemes 1-3 illustrate the methods employed in the synthesis of the compounds of the present invention of formula I, II, and III. All substituents are as defined above unless indicated otherwise.

The synthesis of the novel compounds of formula I, II, and III which are the subject of this invention may be accomplished by one or more of several similar routes. The compounds of the present invention can be prepared from diaryl imidazole carboxamides such as those of formula V and a substituted piperazine such as VI using standard coupling conditions followed by additional modifications. The preparation of these intermediates is described in the following Schemes, wherein X, R¹, R², R³, R⁴, R⁵, R⁶, R⁷, R⁸, R⁹ and R¹⁰ are defined above.

Intermediates of formula V are known in the literature or may be conveniently prepared by a variety of methods familiar to those skilled in the art. One route described in the literature (J. H. M. Lange, et. al. J. Med. Chem. 2005, 48, 1823 and I. K. Khanna, et. al. J. Med. Chem. 1997, 40, 1634) is illustrated in Scheme 1. Intermediates of formula 1 and 2, which are either commercially available or known in the literature, are treated with a base such as potassium bis(trimethylsilyl)amide to provide the diaryl amidine 3. Heating amidine 3 with methyl or ethyl bromopyruvate in the presence of a base such as sodium bicarbonate in a solvent such as 2-propanol, 1,4-dioxane, or tetrahydrofuran affords imidazole 4. Subsequent hydrolysis of the ester with, for example, lithium or sodium hydroxide provides acid V.

Intermediates VI are commercially available, known in the literature, or may be prepared as illustrated in Scheme 2 from intermediates 5 and 6. Intermediates 5, wherein L is a suitable nitrogen protecting group such as tert-butoxycarbonyl (Boc), benzyloxycarbonyl (Cbz), or trityl (Tr), are either commercially available or known in the literature. Intermediates 6, wherein Y is Cl, Br, I, or triflate, are either commercially available, known in the literature, or conveniently prepared by a variety of methods familiar to those skilled in the art. Intermediates 7 may be prepared by heating 5 and 6 together in the presence of a base such as sodium tert-butoxide, potassium phosphate, or cesium carbonate in a solvent such as toluene, 1,4-dioxane, or tetrahydrofuran with catalytic amounts of a palladium II source and a trisubstituted phosphine according to procedures outlined in J. P. Wolfe, et. al. J. Org. Chem. 2000, 65, 1144 and J. P. Wolfe, et. al. J. Org. Chem. 2000, 65, 1158. After coupling, the protecting group of 7 is then removed with, for example, trifluoroacetic acid or methanolic hydrogen chloride in the case of Boc to give the desired amine intermediate VI.

Compound I may be prepared as illustrated in Scheme 3 by coupling intermediates V and VI under standard peptide coupling conditions, for example, using EDC and HOBT, or HATU and HOAT in the presence of a base such as DIEA or triethylamine in a solvent such as DMF or dichloromethane for 3 to 48 hours at ambient temperature to provide compound I where X and R¹ to R¹⁰ are described above. The product is purified from unwanted side products, if necessary, by recrystallization, trituration, preparative thin layer chromatography, flash chromatography on silica gel, such as with a Biotage® apparatus, or HPLC. Compounds that are purified by HPLC may be isolated as the corresponding salt. Purification of intermediates is achieved in the same manner.

In some cases the product, compound I, or the synthetic intermediates illustrated in the above schemes may be further modified, for example, by manipulation of the naphthylene R¹⁰ substituents. These manipulations may include, but are not limited to, reduction, oxidation, alkylation, arylation, condensation, acylation, and hydrolysis reactions that are commonly known to those skilled in the art. One such example is illustrated in Scheme 4. Hydrolysis of ester Ia with, for example, lithium or sodium hydroxide provides acid Ib.

In some cases the order of carrying out the foregoing reaction schemes may be varied to facilitate the reaction or to avoid unwanted reaction products. The following intermediates and examples are provided to illustrate the invention and are not to be construed as limiting the scope of the invention in any manner.

Intermediate 1 1-(3-Methoxyphenyl)-2-(4-methylphenyl)-1H-imidazole-4-carboxylic acid

Step A: N-(3-Methoxyphenyl)-4-methylbenzenecarboxamidine To a solution of 2.5 mL (5.0 mmol) of 2.0 M (in tetrahydrofuran) sodium bis(trimethylsilyl)amide in 10 mL of tetrahydrofuran at ambient temperature was added a solution of 0.59 g (5.0 mmol) of p-tolunitrile in 20.0 mL of tetrahydrofuran and the resulting solution was stirred for 30 min. To this reaction mixture was slowly added 0.56 mL (5.0 mmol) of 3-methoxyaniline. The resulting mixture was stirred at ambient temperature overnight and then poured into ice/water (25 mL) and extracted with dichloromethane (50 mL). The organic layer was separated and the aqueous layer was extracted with dichloromethane (25 mL). The combined organic layers were dried over magnesium sulfate, filtered and concentrated in vacuo to yield the title compound as yellow solid which was used without further purification. LC/MS 241.1 (M+1).

Step B: Methyl 1-(3-methoxyphenyl)-2-(4-methylphenyl)-1H-imidazole-4-carboxylate To a mixture of 1.0 g (4.2 mmol) of the compound from Step A and 0.71 g (8.4 mmol) of sodium bicarbonate in 35 mL of 2-isopropanol was added 1.1 mL (8.4 mmol) of ethyl bromopyruvate. The reaction mixture was refluxed overnight. After cooling to room temperature, the mixture was concentrated, dichloromethane (30 mL) was added, and washed successively with water (3×40 mL) and brine (3×40 mL) and dried over magnesium sulfate. The filtrate was concentrated in vacuo. Flash chromatography on a Biotage Horizon® system (silica gel, 40 to 60% ethyl acetate in hexanes gradient) gave the title compound as a yellow oil: LC/MS 337.1 (M+1).

Step C: 1-(3-Methoxyphenyl)-2-(4-methylphenyl)-1H-imidazole-4-carboxylic acid To a solution of 0.38 g (1.1 mmol) of the compound from step B in 10 mL of tetrahydrofuran, and 5 mL of methanol was added 4.0 mL (4.0 mmol) of 1.0 M#NaOH solution. The reaction mixture was stirred at 50° C. for 2 h. The mixture was partitioned between 2.0 M hydrochloric acid (2 mL), water (10 mL) and ethyl acetate (40 mL) and the organic layer was separated. The aqueous layer was extracted with ethyl acetate (10 mL), and the combined organic layers were dried over magnesium sulfate, filtered and concentrated in vacuo to yield the title compound as a brown foam. LC/MS 309.2 (M+1).

Intermediate 2 1-(3-Ethoxyphenyl)-2-(4-methylphenyl)1H-imidazole-4-carboxylic acid

Step A: N-(3-Ethoxyphenyl)-4-methylbenzenecarboxamidine To a solution of 2.2 ml (4.4 mmol) of 2.0 M (in tetrahydrofuran) sodium bis(trimethylsilyl)amide in 5.0 mL of tetrahydrofuran at ambient temperature was added 0.52 mL (4.0 mmol) of 3-ethoxyaniline and the resulting solution was stirred for 20 min. To this reaction mixture was slowly added a solution of 0.47 g (4.0 mmol) of p-tolunitrile in 2.0 mL of tetrahydrofuran. The resulting mixture was stirred at ambient temperature for 5 hrs and then poured into brine (25 mL) and dichloromethane (50 mL). The organic layer was separated and the aqueous layer was extracted with dichloromethane (25 mL). The combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as yellow solid which was used without further purification. LC/MS 255.2 (M+1).

Step B: Ethyl 1-(3-ethoxyphenyl)-2-(4-methylphenyl)-1H-imidazole-4-carboxylate To a mixture of 1.1 g (4.0 mmol) of the compound from Step A and 0.80 g (9.5 mmol) of sodium bicarbonate in 10 mL of 1,4-dioxane was added 0.60 mL (4.8 mmol) of ethyl bromopyruvate. The reaction mixture was refluxed overnight. After cooling to room temperature, the solid was filtered off and the filtrate was concentrated in vacuo. Flash chromatography on a Biotage Horizon® system (silica gel, 5 to 40% ethyl acetate in hexanes gradient then 40% ethyl acetate in hexanes) gave the title compound as a yellow oil. LC/MS 351.2 (M+1).

Step C: 1-(3-Ethoxyphenyl)-2-(4-methylphenyl)-1H-imidazole-4-carboxylic acid To a solution of 0.75 g (2.1 mmol) of ethyl 1-(3-ethoxyphenyl)-2-(4-methylphenyl)-1H-imidazole-4-carboxylate in 10 mL of tetrahydrofuran, 5 mL of water and 5 mL of methanol was added 0.80 mL (4.0 mmol) of 5.0 M NaOH solution. The reaction mixture was stirred at ambient temperature overnight. Next, hydrochloric acid (2.0 M) was added to neutralize the reaction mixture. After removal of the organic solvents in vacuo, dichloromethane (20 mL) was added and the organic layer was separated. The aqueous layer was extracted with dichloromethane (10 mL), and the combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as a yellow foam. LC/MS 323.3 (M+1).

Intermediate 3 1-(2,3-Dihydro-1,4-benzodioxin-6-yl)-2-(4-methylphenyl)-1H-imidazole-4-carboxylic acid

Step A: N-(2,3-Dihydro-1,4-benzodioxin-6-yl)-4-methylbenzenecarboxamidine To a solution of 0.605 g (4.0 mmol) of 1,4-benzodioxan-6-amine in 5 mL of tetrahydrofuran at ambient temperature was added 2.2 ml (4.4 mmol) of 2.0 M (in tetrahydrofuran) sodium bis(trimethylsilyl)amide and the resulting solution was stirred for 20 min. To this reaction mixture was slowly added a solution of 0.47 g (4.0 mmol) of p-tolunitrile in 2 mL of tetrahydrofuran. The resulting mixture was stirred at ambient temperature for 5 hrs and then poured into brine (25 mL) and dichloromethane (50 mL). The organic layer was separated and the aqueous layer was extracted with 25 mL of dichloromethane (25 mL). The combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as brown crystalline solid, which was used without further purification. LC/MS 269.2 (M+1).

Step B: Ethyl 1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-methylphenyl)-1H-imidazole-4-carboxylate To a mixture of the compound from Step A and 0.80 g (9.5 mmol) of sodium bicarbonate in 10 mL of 1,4-dioxane was added 0.60 mL (4.8 mmol) of ethyl bromopyruvate. The reaction mixture was refluxed overnight. After cooling to room temperature, the solid was filtered off and the filtrate was concentrated in vacuo. Flash chromatography on a Biotage Horizon® system (silica gel, 0 to 50% ethyl acetate in hexanes gradient) gave the title compound as a yellow foam. LC/MS 365.3 (M+1).

Step C: 1-(2,3-Dihydro-1,4-benzodioxin-6-yl-2-(4-methylphenyl)-1H-imidazole-4-carboxylic acid To a solution of 0.62 g (1.7 mmol) of the compound from Step B in 10 mL of tetrahydrofuran, 5 mL of water and 5 mL of methanol was added 0.80 mL (4.0 mmol) of 5.0 M NaOH solution. The reaction mixture was stirred at ambient temperature overnight. Hydrochloric acid (2.0 M) was then added to neutralize the reaction mixture. After removal of the organic solvents in vacuo, dichloromethane (20 mL) was added and the organic layer was separated. The aqueous layer was extracted with dichloromethane (10 mL), and the combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as a yellow foam. LC/MS 337.3 (M+1).

Intermediate 4 1-(3-Ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazole-4-carboxylic acid

Step A: N-(3-Ethoxyphenyl)-4-fluorobenzenecarboximidamide To a solution of 2.2 ml (4.4 mmol) of 2.0 M (in tetrahydrofuran) sodium bis(trimethylsilyl)amide in 5.0 mL of tetrahydrofuran at ambient temperature was added 0.52 mL (4.0 mmol) of 3-ethoxyaniline and the resulting solution was stirred for 20 min. To this reaction mixture was slowly added a solution of 0.48 g (4.0 mmol) of 4-fluorobenzonitrile in 2.0 mL of tetrahydrofuran. The resulting mixture was stirred at ambient temperature for 5 hrs and then poured into brine (25 mL) and dichloromethane (50 mL). The organic layer was separated and the aqueous layer was extracted with dichloromethane (25 mL). The combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as yellow solid which was used without further purification. LC/JMS 259.2 (M+1).

Step B: Ethyl 1-(3-ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazole-4-carboxylate To a mixture of the compound from Step A and 0.80 g (9.5 mmol) of sodium bicarbonate in 10 mL of 1,4-dioxane was added 0.60 mL (4.8 mmol) of ethyl bromopyruvate. The reaction mixture was refluxed overnight. After cooling to room temperature, the solid was filtered off and the filtrate was concentrated in vacuo. Flash chromatography on a Biotage Horizon® system (silica gel, 0 to 30% ethyl acetate in hexanes gradient then 30% ethyl acetate in hexanes) gave the title compound as a viscous yellow oil. LC/MS 355.3 (M+1).

Step C: 1-(3-Ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazole-4-carboxylic acid To a solution of 0.67 g (1.9 mmol) of ethyl 1-(3-ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazole-4-carboxylate in 10 mL of tetrahydrofuran, 5 mL of water and 5 mL of methanol was added 0.80 mL (4.0 mmol) of 5.0 M NaOH solution. The reaction mixture was stirred at ambient temperature overnight. Hydrochloric acid (2.0 M) was then added to neutralize the reaction mixture. After removal of the organic solvents in vacuo, dichloromethane (20 mL) was added and the organic layer was separated. The aqueous layer was extracted with dichloromethane (10 mL), and the combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as a pale yellow solid. LC/MS 327.2 (M+1).

Intermediate 5 1-(3-Ethoxyphenyl)-2-(2,4-difluorophenyl)-1H-imidazole-4-carboxylic acid

Step A: N-(3-Ethoxyphenyl)-2,4-difluorobenzenecarboximidamide To a solution of 2.2 ml (4.4 mmol) of 2.0 M (in tetrahydrofuran) sodium bis(trimethylsilyl)amide in 10 mL of tetrahydrofuran at ambient temperature was added 0.52 mL (4.0 mmol) of 3-ethoxyaniline and the resulting solution was stirred for 20 min. The reaction mixture was cooled to −78° C. and then was added 0.57 ml (4.0 mmol) of 2,4-difluorobenzonitrile. The resulting mixture was stirred from −78° C. to ambient temperature for 5 hrs and then poured into brine (25 mL) and dichloromethane (50 mL). The organic layer was separated and the aqueous layer was extracted with dichloromethane (25 mL). The combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo. Flash chromatography on a Biotage Horizon® system (silica gel, 0 to 50% ethyl acetate in hexanes gradient) gave the title compound as a yellow oil. LC/MS 277.2 (M+1).

Step B: Ethyl 1-(3-ethoxyphenyl)-2-(2,4-difluorophenyl)-1H-imidazole-4-carboxylate To a mixture of 0.112 g (0.41 mmol) of the compound from Step A and 0.10 g (1.2 mmol) of sodium bicarbonate in 5 mL of 1,4-dioxane was added 0.0 mL (0.80 mmol) of ethyl bromopyruvate. The reaction mixture was refluxed overnight. After cooling to room temperature, the solid was filtered off and the filtrate was concentrated in vacuo. Flash chromatography on a Biotage Horizon® system (silica gel, 0 to 50% ethyl acetate in hexanes gradient) gave the title compound as a viscous yellow oil. LC/MS 373.2 (M+1).

Step C: 1-(3-Ethoxyphenyl)-2-(2,4-difluorophenyl)-1H-imidazole-4-carboxylic acid To a solution of 0.10 g (0.27 mmol) of ethyl 1-(3-ethoxyphenyl)-2-(2,4-difluorophenyl)-1H-imidazole-4-carboxylate in 2 mL of tetrahydrofuran, 1 mL of water and 1 mL of methanol was added 0.20 mL (1.0 mmol) of 5.0 M NaOH solution. The reaction mixture was stirred at ambient temperature for 4 hrs. Hydrochloric acid (2.0 M) was then added to neutralize the reaction mixture. After removal of the organic solvents in vacuo, dichloromethane (10 mL) was added and the organic layer was separated. The aqueous layer was extracted with dichloromethane (5 mL), and the combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as a yellow foam. LC/MS 345.0 (M+1).

Intermediate 6 1-(3-Ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazole-4-carboxylic acid

Step A: N-(3-Ethoxyphenyl)-2-fluoro-4-methylbenzenecarboximidamide To a solution of 2.2 ml (4.4 mmol) of 2.0 M (in tetrahydrofuran) sodium bis(trimethylsilyl)amide in 10 mL of tetrahydrofuran at ambient temperature was added 0.52 mL (4.0 mmol) of 3-ethoxyaniline and the resulting solution was stirred for 20 min. To this reaction mixture was added 0.54 g (4.0 mmol) of 4-fluoro-4-methylbenzonitrile. The resulting mixture was stirred at ambient temperature for 3 hrs and then poured into brine (25 mL) and dichloromethane (50 mL). The organic layer was separated and the aqueous layer was extracted with dichloromethane (25 mL). The combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as a pale green solid, which was used without further purification. LC/MS 273.2 (M+1).

Step B: Ethyl 1-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazole-4-carboxylate To a mixture of the compound from Step A and 0.80 g (9.5 mmol) of sodium bicarbonate in 10 mL of 1,4-dioxane was added 0.60 mL (4.8 mmol) of ethyl bromopyruvate. The reaction mixture was refluxed overnight. After cooling to room temperature, the solid was filtered off and the filtrate was concentrated in vacuo. Flash chromatography on a Biotage Horizon® system (silica gel, 0 to 50% ethyl acetate in hexanes gradient) gave the title compound as a viscous yellow oil. LC/MS 369.2 (M+1).

Step C: 1-(3-Ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazole-4-carboxylic acid To a solution of 0.81 g (2.2 mmol) of ethyl 1-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazole-4-carboxylate in 10 mL of tetrahydrofuran, 5 mL of water and 5 mL of methanol was added 1.0 mL (5.0 mmol) of 5.0 M NaOH solution. The reaction mixture was stirred at ambient temperature overnight. Hydrochloric acid (2.0 M) was then added to neutralize the reaction mixture. After removal of the organic solvents in vacuo, dichloromethane (20 mL) was added and the organic layer was separated. The aqueous layer was extracted with dichloromethane (10 mL), and the combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as a yellow foam. LC/MS 341.1 (M+1).

Intermediate 7 1-(2,3-Dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazole-4-carboxylic acid

Step A: N-(2,3-Dihydro-1,4-benzodioxin-6-yl)-4-fluorobenzenecarboxamidine To a solution of 2.39 g (15.8 mmol) of 1,4-benzodioxan-6-amine in 30 mL of tetrahydrofuran at ambient temperature was added 8.7 ml (17.4 mmol) of 2.0 M (in tetrahydrofuran) sodium bis(trimethylsilyl)amide and the resulting solution was stirred for 20 min. To this reaction mixture was added 1.91 g (15.8 mmol) of 4-fluorobenzonitrile all at once. The resulting mixture was stirred at ambient temperature overnight and then poured into brine (50 mL) and dichloromethane (150 mL). The organic layer was separated and the aqueous layer was extracted with dichloromethane (50 mL). The combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as yellow solid which was used without further purification. LC/MS 273.2 (M+1).

Step B: Ethyl 1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazole-4-carboxylate To a mixture of the compound from Step A and 4.0 g (48 mmol) of sodium bicarbonate in 50 mL of 1,4-dioxane was added 3.0 mL (24 mmol) of ethyl bromopyruvate. The reaction mixture was refluxed overnight. After cooling to room temperature, the solid was filtered off and the filtrate was concentrated in vacuo. Flash chromatography on a Biotage Horizon® system (silica gel, 0 to 50% ethyl acetate in hexanes gradient) gave the title compound as yellow solid. LC/MS 369.1 (M+1).

Step C: 1-(2,3-Dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazole-4-carboxylic acid To a solution of 2.1 g (5.7 mmol) of ethyl 1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazole-4-carboxylate in 20 mL of tetrahydrofuran, 10 mL of water and 10 mL of methanol was added 2.0 mL (10 mmol) of 5.0 M NaOH solution. The reaction mixture was stirred at ambient temperature overnight. Hydrochloric acid (2.0 M) was then added to neutralize the reaction mixture. After removal of the organic solvents in vacuo, dichloromethane (20 mL) was added and the organic layer was separated. The aqueous layer was extracted with dichloromethane (10 mL), and the combined organic layers were dried over sodium sulfate, filtered and concentrated in vacuo to yield the title compound as a pale yellow foam. LC/MS 341.0 (M+1).

Example 1 1-{[2-(2,4-Difluorophenyl)-1-(3-ethoxyphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine

Step A: 1-{[2-(2,4-Difluorophenyl)-(3-ethoxyphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine To a mixture of 0.011 g (0.052 mmol) of 1-(2-naphthyl)piperazine, 0.015 g (0.078 mmol) of N-(3-dimethylaminopropyl)-N′-ethylcarboiimide hydrochloride and 0.010 g (0.074 mmol) of 1-hydroxybenzotriazole in 0.5 ml of N,N-dimethylformamide was added 0.050 mL (0.29 mmol) of diisopropylethylamine followed by 0.017 g (0.049 mmol) of intermediate 5. The solution was allowed to stir at room temperature overnight. The reaction was quenched with 0.1% trifluoroacetic acid in acetonotrile (0.5 mL), and the reaction mixture was purified directly by reverse phase HPLC (TMC Pro-Pac C18; 40-90% 0.1% trifluoroacetic acid in acetonitrile/0.1% trifluoroacetic acid in water gradient). The pure fractions were lyophilized overnight to give the title compound as a white solid. ¹H NMR (DMSO-d₆): , 8.10 (s, 1H), 7.76 (d, J=9.2 Hz, 1H), 7.74 (d, J=8.2 Hz, 1H), 7.71 (d, J=8.0 Hz, 1H), 7.65 (td, J=8.5, 6.7 Hz, 1H), 7.41-7.36 (m, 2H), 7.30-7.19 (m, 5H), 6.94 (dd, J=8.4, 2.2 Hz, 1H), 6.88 (t, J=2.2 Hz, 1H), 6.77 (dd, J=7.9, 1.5 Hz, 1H), 4.47 (s, 2H), 3.96 (q, J=7.0 Hz, 2H), 3.83 (s, 2H), 3.34-3.32 (m, 4H), 1.24 (t, J=7.0 Hz). LC/MS 539.2 (M+1).

The compounds in Table 1 were prepared using the appropriate starting materials and reagents following procedures similar to those described above for Example 1:

TABLE 1

MS Example R¹⁰ R¹ R² R³ R⁴ R⁶ R⁷ (M + 1) 2 H H OMe H H Me H 503.5 3 H H OEt H H Me H 517.3 4 H H OH H H Me H 489.2 5 H 2- OMe H H Me H 533.3 MeO 6 H H OiPr H H Me H 531.4 7 H H Et H H Me H 501.4 8 H H H OMe H Me H 503.4 9 H H OEt H H F H 521.4 10 H H OEt H H H H 503.2 11 H H OEt H H Cl H 536.8 12 H H OEt H H H F 521.4 13 H H OEt H H Et H 531.4 14 H H OEt H H OMe H 533.4 15 H H OEt H H CF₃ H 571.4 16 H H OMe H 5-F Me H 521.3 17 H H OEt H H Me F 535.2

Example 18 1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine

Step) A: 1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine To a solution of 30 mg (0.088 mmol) of intermediate 7 and 21 mg (0.10 mmol) of 1-(2-naphthyl)piperazine in 1 mL of N,N-dimethylformamide was added 21 mg (0.11 mmol) of N-(3-dimethyl-aminopropyl)-N′-ethylcarboiimide hydrochloride, 14 mg (0.11 mmol) of 1-hydroxybenzotriazole, and 0.046 mL (0.26 mmol) of diisopropylethylamine. The solution was stirred at room temperature overnight. The reaction was quenched with 0.1% trifluoroacetic acid in water (1 mL), and the reaction mixture was purified directly by reverse phase HPLC (TMC Pro-Pac C18; 30-100% 0.1% trifluoroacetic acid in acetonitrile/0.1% trifluoroacetic acid in water gradient). The pure fractions were lyophilized overnight to yield a yellow solid. ¹H NMR (CD₃OD): δ 8.01 (s, 1H), 7.78 (d, J=9.0 Hz, 1H), 7.74 (d, J=8.8 Hz, 2H), 7.51 (m, 2H), 7.39 (m, 2H), 7.30 (t, J=8.2 Hz, 1H), 7.17 (t, J=8.7 Hz, 2H), 6.94 (m, 2H), 6.83 (dd, J=8.7, 2.5 Hz, 1H), 4.28 (m, 4H), 4.06 (br, 4H), 3.44 (m, 4H). LC/MS 535.2 (M+1).

The compounds in Table 2 were prepared using the appropriate starting materials and reagents following procedures similar to those described above for Example 18:

TABLE 2

Example R⁶ Y Z n MS (M + 1) 19 Me O O 1 531.4 20 Me O O 0 517.4 21 Me CH₂ O 1 529.3 22 Me CH₂ NH 0 514.3

Biological Assays

A. Cholecystokinin-1 Receptor (CCK1R) and Cholecystokinin-2 Receptor (CCK2R) Binding Assays

Cells were cultured to confluence and harvested by aspirating culture medium and rinsed twice with 1×PBS without Mg⁺⁺ and Ca⁺⁺. 3 ml of Cell Dissociate Solution was added to each T-175 flask until all cells dissociated and then an additional 15 ml 1×PBS without Mg⁺⁺ and Ca⁺⁺ was added to each flask. Dissociated cells were collected in a centrifuge tube by centrifuging at 1000 rpm for 10 min. The cell pellet was homogenized at 4° C. using a Polytron (setting 40, 20 stokes) in about 10 ml/T175 flask membrane preparation buffer (10 mM Tris pH 7.4, 0.01 mM Pefabloc, 10 μM phosphoramidon and 40 μg/ml Bacitracin). After centrifugation at 2200 rpm (1000×g) for 10 min at 4° C., the supernatant was transferred to a clean centrifuge tube and spun at 18,000 rpm (38,742×g) for 15 min. at 4° C. Membranes were resuspended with the above membrane preparation buffer (1000 μl per T-175 flask), homogenized, aliquoted, quickly frozen in liquid nitrogen and stored at −80° C. The specific binding of ¹²⁵I-Bolton Hunter-CCK-8S to CCK1R or CCK2R was measured by filtration binding assay in 96 well plate format. 0.5 μg membrane/well in binding buffer (50 mM Tris pH 7.4, 5 mM MgCl₂, 200 μg/ml Bacitracin and protease inhibitor cocktail) was mixed with agonists in 1% DMSO (final concentration) and 0.1 nM ¹²⁵I-Bolton Hunter-CCK-8S was added. After incubation for 1-2 hrs at room temperature, membrane-bound ¹²⁵I-Bolton Hunter-CCK8S was separated from the free ¹²⁵I-Bolton Hunter-CCK8S by filtering through GF/C filters presoaked in 0.2% BSA solution. The filters were washed with ice-cold washing buffer (50 mM Tris pH 7.4, 10 mM MgCl₂, 2 mM EDTA and 0.04% Tween 20). The radioactivity was determined by adding 30 μl of microscintillant/well after each plate was dried at room temperature overnight or placed at 55° C. for 30 mins. A Packard Top Count was then used to read each filter plate. The data in cpms was plotted vs. the log molar concentration of receptor ligand (compound). The IC₅₀ was reported as the inflection point of the resulting sigmoidal curve. The maximum inhibition observed at the highest compound concentration was reported for compounds which do not generate a curve.

B. Cell Culture of Cholecystokinin-1 Receptor (CCK1R) and Cholecystokinin-2 Receptor (CCK2R) Cell Lines

Stable CHO cell lines expressing the human CCK1R, and CCK2R cDNA and stable HEK293 cell lines expressing the human CCK2R cDNA were generated using standard cell biology techniques. One CCK1R clone identified as CHO_WT23 was used for both FLIPR and IP3 functional and binding assays. One CCK2R clone called CHO_B101 was used for FLIPR functional assays and another CCK2R clone, CHO_hCCK2R, was used for IP3 functional assays. Both WT23 and B101 cells were routinely cultured in T175 flasks in Iscoves Modified Dulbecco's Medium (Invitrogen #12440-046) supplemented with 10% FBS (cat #SH30070.03, Hyclone, Logan, Utah), 1X HT Supplement (0.1 mM Sodium Hypoxanthine and 16 μM Thymidine), 100 units/ml Pennicillin-G and 100 μg/ml Streptomycin, 2 mM L-Glutamine and 1 mg/ml Geneticin. hCCK2R/CHO/Flip-in cells were routinely cultured in T175 flasks in F-12 Nutrient Mixture (Ham) supplemented with 10% FBS (cat#SH30070.03, Hyclone, Logan, Utah), 100 units/ml Pennicillin-G and 100 μg/ml Streptomycin, 2 mM L-Glutamine and 150 μg/ml Hygromycin. One Hek293 hCCK2R clone identified as Hek293_hCCK2R#37 was used for binding assays. Hek293_hCCK2R#37 cells were routinely cultured in T175 flasks in Dulbecco's Modified Eagle Medium, with high glucose (Invitrogen Cat #11965-084) supplemented with 10% FBS (cat#SH30070.03, Hyclone, Logan, Utah), 25 mM of HEPES Buffer Solution (Invitrogen cat #15630-080), 500 μg/ml Geneticin (Invitrogen cat#10131-027) and 200 μg/ml Hygromycin. Cells were grown as attached monolayers in tissue culture flasks under appropriate media in an incubator at 37° C. with 5% CO₂. Cells were passed 1:5 for CHO_WT23, B101 and CHO_hCCK2R cells and 1:3 for HEK 293_hCCK2R#37 twice a week. Cell culture media, antibiotics, Fetal Bovine Serum were all from Invitogen Technologies Inc. unless otherwise specified.

C. Cholecystokinin-1 Receptor (CCK1R) and Cholecystokinin-2 Receptor (CCK2R) Functional Assays

1) FLIPR (Fluorometric Imaging Plate Reader, Molecular Devices, Sunnyvale, Calif.)

CHO_WT23 and B101 cells cultured as described above were detached with Trypsin-EDTA and 20 μl volume of cells were seeded in 384 well plate at 62,500 cells/ml The cells grew overnight at 37° C. with 5% CO₂ in a humidified atmosphere. On the day of the assay, the cells were loaded with 20 μl/well of No-wash assay buffer (HBSS, 0.1% BSA, 20 mM HEPES, 2.5 mM Probenecid and 1.6 mM TR40 Quenching Solution) containing 8 μM Fluo-4 AM in the dark at room temperature for 1.5 hrs. Agonists were dissolved in DMSO and diluted into assay buffer. 13.3 μl/well of 4× concentration of agonist solution was added to cells while measuring fluorescence. The EC₅₀ for activation of the CCK1R or CCK2R receptor was reported as the inflection point of the resulting sigmoidal curve.

2) Inositol Phosphate Spa Assay (IP3) to Measure IP3 Accumulation

This functional assay was performed in a 96-well format. On the first day, 75 μl of CHO cells at 62,500/ml were plated on poly-D-lysine plates. On the afternoon of the next day, the plates were aspirated, and the cells were washed with PBS w/o Mg⁺⁺, Ca⁺⁺. Next 150 μl of ³H-inositol labeling media, Inositol-free DMEM media ICN #1642954 supplemented with 10% FBS, 1× pen/strep/glutamine to which ³H-myo-inositol (NEN #NET114A) was added, 1 mCi/ml, 25 Ci/mmol diluted 1:150 in loading medium (final specific radioactivity of 1 μCi/150 μl). After 18 hours of labeling, 5 μl 300 mM LiCl was added to the wells, mixed, and incubated for 20 minutes at 37° C., then 1.5 μl DMSO of 200× compounds were added to wells and incubated for an additional 90 minutes at 37° C. Plates were aspirated, and then the reaction was terminated and cells were lysed with the addition of 60 μl 10 mM formic acid for 60 minutes at room temperature. 20 μl of lysate was transferred to clear-bottom Opti-plates which contained RNA binding YSi SPA-beads (Amersham RPNQ0013) that were suspended in 10% glycerol at 1 mg beads/70 μl of solution and dispensed at 70 μl per well. After mixing, the plates sit at room temperature for 2 hrs and were then counted using a Wallac Microbeta reader. The EC₅₀ for activation of the CCK1F or CCK2R receptor was calculated from the titration curve of the compounds.

D. In Vivo Overnight Food Intake and Body Weight in C57 Lean Male Mice

Methods: Male C57 mice, approximately 8 weeks old (weighing approximately 25 g) were individually housed and acclimated for several days prior to testing. Mice were orally dosed (PO; n=8) with either vehicle controls (10% Tween-water) or CCK1R agonists (various doses). A known CB1 inverse agonist, AM251 (3 mg/kg) was used as the positive control for inter- and intra-experimental control. CCK1R agonists were dosed (PO) approximately 60-120 minutes prior to the onset of the dark cycle. Overnight food intake (g) and body weight (g) (±SEM) were collected and analyzed. All data were presented as mean±SEM (n=8). Statistical significance was calculated using Student's t-test to determine whether compared the groups were statistically distinct. Differences were considered significant when p<0.05.

Compounds useful in the present invention decrease overnight food intake by at least 10% and/or decrease body weight overnight by at least 1% relative to placebo.

E. Mouse Gallbladder Emptying Assay for CCK-1R Binding Specificity

Methods: Male CD-1 mice, approximately 7-8 weeks old (weighing 25 g) were housed (8 mice per cage), and fasted for 18 hours with ad lib access to water. Mice were orally dosed (PO; n=8) with either vehicle controls (10% Tween-water) or CCK1R agonists (various doses) for 4 h. After 4 h, mice were deeply anesthetized with CO₂ inhalant; blood samples were drawn via cardiac puncture and stored at −20° C. (for future assays). Gall bladders were isolated, removed and weighed. Gallbladder weights were normalized to body weight (g/kg) and compared to vehicle control group. The entire assay typically required approximately 30-40 minutes for tissue collection. All data were presented as mean±SEM (n=8) and Statistical significance was calculated using Student's t-test to determine whether compared the groups were statistically distinct. Differences were considered significant when p<0.05.

Representative compounds of the present invention were tested and found to bind to the cholecystokinin-1 receptor. Representative compounds of the present invention were found to have IC₅₀ values less than or equal to 500 nM. Representative compounds of the present invention were also tested in the functional assay and found to activate the cholecystokinin-1 receptor with EC₅₀ values less than or equal to 500 nM.

Examples of Pharmaceutical Compositions

As a specific embodiment of an oral composition of a composition of the present invention, 5 mg of Example 1 is formulated with sufficient finely divided lactose to provide a total amount of 580 to 590 mg to fill a size 0 hard gelatin capsule.

As another specific embodiment of an oral composition of a compound of the present invention, 2.5 mg of Example 1 is formulated with sufficient finely divided lactose to provide a total amount of 580 to 590 mg to fill a size 0 hard gelatin capsule.

While the invention has been described and illustrated in reference to certain preferred embodiments thereof, those skilled in the art will appreciate that various changes, modifications and substitutions can be made therein without departing from the spirit and scope of the invention. For example, effective dosages other than the preferred doses as set forth hereinabove may be applicable as a consequence of variations in the responsiveness of the subject or mammal being treated obesity, diabetes, obesity-related disorders, or for other indications for the compounds of the invention indicated above. Likewise, the specific pharmacological responses observed may vary according to and depending upon the particular active compound selected or whether there are present pharmaceutical carriers, as well as the type of formulation and mode of administration employed, and such expected variations or differences in the results are contemplated in accordance with the objects and embodiments of the present invention. It is intended, therefore, that the invention be limited only by the scope of the claims which follow and that such claims be interpreted as broadly as is reasonable. 

1. A compound of formula I:

or a pharmaceutically acceptable salt thereof; wherein X is N or CR¹⁶; R¹, R², R³ and R⁴ are each independently selected from the group consisting of: (1) hydrogen, (2) halogen, (3) —OH, (4) —C₁₋₆alkyl, and (5) —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents independently selected from halogen, OH, C₁₋₆alkyl, and C₁₋₆alkoxy, or R² and R³ or R³ and R⁴ together with the atoms to which they are attached form a 4-8 membered ring containing 0-2 heteroatoms ndependently selected from oxygen, and N—R¹⁵, and wherein the 4-8 membered ring is unsubstituted or substituted with a substituent selected from —OH, halogen, C₁₋₆alkyl, and C₁₋₆alkoxy; R⁵, R⁶ and R⁷ are each independently selected from the group consisting of: (1) hydrogen, (2) halogen, (3) —OH, (4) —C₁₋₆alkyl, and (5) —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents independently selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy; R⁸ is hydrogen; each R⁹ is hydrogen; each R¹⁰ is —C₁₋₆alkyl; each R¹⁵ is independently selected from the group consisting of: (1) hydrogen, (2) —C₁₋₆alkyl, each R¹⁶ is independently selected from the group consisting of: hydrogen, —OH and —C₁₋₆alkyl; each n is independently 0, 1, 2, or 3; and p is 0, 1, or
 2. 2. The compound of claim 1 wherein m is 0 and p is 0; or a pharmaceutically acceptable salts thereof.
 3. The compound of claim 1 wherein X is N or CH; or a pharmaceutically acceptable salt thereof.
 4. The compound of claim 3 wherein X is N; or a pharmaceutically acceptable salt thereof.
 5. The compound of claim 1 wherein n is
 0. 6. The compound of claim 1 wherein n is 1, 2 or
 3. 7. The compound of claim 1 of formula II:

or a pharmaceutically acceptable salt thereof; wherein R¹, R², R³ and R⁴ are each independently selected from the group consisting of: (1) hydrogen, (2) halogen, (3) —OH, (4) —C₁₋₆alkyl, and (5) —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy; R⁵, R⁶ and R⁷ are each independently selected from the group consisting of (1) hydrogen, (2) halogen, (3) —C₁₋₆alkyl, and (4) —C₁₋₆alkoxy, wherein alkyl and alkoxy are unsubstituted or substituted with one to five substituents selected from halogen, —OH, C₁₋₆alkyl, and C₁₋₆alkoxy; R⁸ is hydrogen; each R⁹ is hydrogen; each R¹⁰ is —C₁₋₆alkyl; each n is independently 0, 1, 2, or
 3. 8. The compound of claim 1 selected from the group consisting of: (1) 1-{[2-(2,4-difluorophenyl)-1-(3-ethoxyphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (2) 1-{[1-(3-methoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (3) 1-{[1-(3-ethoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (4) 1-{[1-(3-hydroxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (5) 1-{[1-(2,3-dimethoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (6) 1-{[1-(3-isopropoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (7) 1-{[1-(3-ethylphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (8) 1-{[1-(4-methoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (9) 1-{[1-(3-ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (10) 1-{[1-(3-ethoxyphenyl)-2-phenyl-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (11) 1-{[1-(3-ethoxyphenyl)-2-(4-chlorophenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (12) 1-{[1-(3-ethoxyphenyl)-2-(2-fluorophenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (13) 1-{[1-(3-ethoxyphenyl)-2-(4-ethylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (14) 1-{[1-(3-ethoxyphenyl)-2-(4-methoxyphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (15) 1-{[1-(3-ethoxyphenyl)-2-(4-trifluoromethylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (16) 1-{[1-(3-ethoxy-5-fluorophenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (17) 1-{[1-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine, (18) 1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, (19) 1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, (20) 1-{[1-(1,3-benzodioxol-5-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, (21) 1-{[1-(3,4-dihydro-2H-chromen-6-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, and (22) 5-(2-(4-methylphenyl)-4-{[4-(2-naphthyl)-1-piperazinyl]carbonyl}-1H-imidazol-1-yl)indoline; or a pharmaceutically acceptable salt thereof.
 9. The compound of claim 8 selected from the group consisting of: (1) 1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, (2) 1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, (3) 1-{[1-(1,3-benzodioxol-5-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, (4) 1-{[1-(3,4-dihydro-2H-chromen-6-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, and (5) 5-(2-(4-methylphenyl)-4-{[4-(2-naphthyl)-1-piperazinyl]carbonyl}-1H-imidazol-1-yl)indoline; or a pharmaceutically acceptable salt thereof.
 10. The compound of claim 8 selected from the group consisting of: 1-{[1-(2,3-dihydro-1,4-benzodioxin-6-yl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, or a pharmaceutically acceptable salt thereof.
 11. The compound of claim 8 selected from the group consisting of: 1-{[1-(1,3-benzodioxol-5-yl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl-4-(2-naphthyl)piperazine, or a pharmaceutically acceptable salt thereof.
 12. The compound of claim 8 which is (1) 1-{[1-(3-ethoxyphenyl)-2-(4-fluorophenyl)-1H-imidazol-4-yl]carbonyl}-4-(2 naphthyl)piperazine; (2) 1-{[1-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; (3) 1-{[2-(2,4-difluorophenyl)-1-(3-ethoxyphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; (4) 1-{[1-(3-methoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; (5) 1-{[1-(3-ethoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; or a pharmaceutically acceptable salt thereof.
 13. The compound of claim 8 which is selected from the group consisting of: 1-{[1-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; or a pharmaceutically acceptable salt thereof.
 14. The compound of claim 8 which is selected from the group consisting of: 1-{[1-(3-methoxyphenyl)-2-(4-methylphenyl)-1H-imidazol-4-yl]carbonyl}-4-(2-naphthyl)piperazine; or a pharmaceutically acceptable salt thereof.
 15. The compound of claim 8 wherein the pharmaceutically acceptable salt thereof is a trifluoroacetic acid salt.
 16. A pharmaceutical composition which comprises a compound of claim 1, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier. 